Imaging Characteristics and Diagnostic Performance of 2-deoxy-2-[18F]fluoro-D-Glucose PET/CT for Melanoma Patients Who Demonstrate Hyperprogressive Disease When Treated with Immunotherapy.,Molecular Imaging and Biology

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Imaging Characteristics and Diagnostic Performance of 2-deoxy-2-[18F]fluoro-D-Glucose PET/CT for Melanoma Patients Who Demonstrate Hyperprogressive Disease When Treated with Immunotherapy.
Molecular Imaging and Biology ( IF 3.0 ) Pub Date : 2020-08-12 , DOI: 10.1007/s11307-020-01526-4
Ryusuke Nakamoto ₁ , Lisa C Zaba ₂ , Jarrett Rosenberg ₁ , Sunil Arani Reddy ₃ , Tomomi W Nobashi ₄ , Valentina Ferri ₁ , Guido Davidzon ₁ , Carina Mari Aparici ₁ , Judy Nguyen ₁ , Farshad Moradi ₁ , Andrei Iagaru ₁ , Benjamin Lewis Franc ₁

Affiliation

Purpose

We investigated the ability of baseline 2-deoxy-2-[¹⁸F]fluoro-d-glucose PET/CT parameters, acquired before the start of immunotherapy, to predict development of hyperprogressive disease (HPD) in melanoma patients. We also evaluated the diagnostic performances of ratios of baseline and first restaging PET/CT parameters to diagnose HPD without information of the tumor growth kinetic ratio (TGKR) that requires pre-baseline imaging before baseline imaging (3 timepoint imaging).

Procedures

Seventy-six patients who underwent PET/CT before and approximately 3 months following initiation of immunotherapy were included. PET/CT parameters, including metabolic tumor volume (MTV) for all melanoma lesions and total measured tumor burden (TMTB) based on irRECIST, were measured from baseline PET/CT (MTV_base and TMTB_base) and first restaging PET/CT (MTV_post and TMTB_post). The ratios of MTV (MTV_post/MTV_base, MTVr) and TMTB (TMTB_post/TMTB_base, TMTBr) were calculated.

Results

MTV_base of HPD patients (n = 9, TGKR ≥ 2) was larger than that of non-HPD (n = 67, TGKR < 2) patients (P < 0.05), and HPD patients demonstrated shorter median overall survival (7 vs. more than 60 months, P < 0.05). The area under the curve (AUC) of MTV_base (≥ 155.5 ml) to predict the risk of HPD was 0.703, with a sensitivity of 66.7 % and specificity of 81.2 %. The AUCs of MTVr (≥ 1.25) and TMTBr (≥ 1.27) to diagnose HPD without information of TGKR were 0.875 and 0.977 with both sensitivities of 100 %, and specificities of 79 % and 83.9 %, respectively.

Conclusions

Patients at high risk of developing HPD could not be accurately identified based on baseline PET/CT parameters. The ratios of baseline and first restaging PET/CT parameters may be helpful to diagnose HPD, when patients do not undergo pre-baseline imaging.

中文翻译：

2-deoxy-2-[18F]fluoro-D-Glucose PET/CT 的成像特征和诊断性能对黑色素瘤患者进行免疫治疗时表现出超进展性疾病。

目的

我们研究基线2-脱氧-2- [能力¹⁸ F]氟- d -葡萄糖PET / CT参数，免疫治疗开始前获得的，在黑色素瘤患者预测hyperprogressive疾病（HPD）的发展。我们还评估了基线和首次再分期 PET/CT 参数的比率的诊断性能，以在没有肿瘤生长动力学比率 (TGKR) 信息的情况下诊断 HPD，而肿瘤生长动力学比率 (TGKR) 需要在基线成像（3 个时间点成像）之前进行基线前成像。

程序

包括在免疫治疗开始前和开始后大约 3 个月接受 PET/CT 的 76 名患者。PET/CT 参数，包括所有黑色素瘤病变的代谢肿瘤体积 (MTV) 和基于 irRECIST 的总测量肿瘤负荷 (TMTB)，从基线 PET/CT（MTV_基础和 TMTB_基础）和第一次再分期 PET/CT（MTV）开始测量_帖子和 TMTB_帖子）。计算MTV(MTV_后/MTV_基，MTVr)和TMTB(TMTB_后/TMTB_基，TMTBr)的比率。

结果

HPD 患者（n = 9，TGKR ≥ 2）的MTV_基数大于非 HPD（n = 67，TGKR < 2）患者（P < 0.05），并且 HPD 患者的中位总生存期较短（7 vs. 60 个月以上，P < 0.05）。MTV_基础（≥ 155.5 ml）预测 HPD 风险的曲线下面积（AUC）为 0.703，敏感性为 66.7%，特异性为 81.2%。在没有 TGKR 信息的情况下，MTVr (≥ 1.25) 和 TMTBr (≥ 1.27) 诊断 HPD 的 AUC 分别为 0.875 和 0.977，敏感性分别为 100%，特异性分别为 79% 和 83.9%。