This study aimed to evaluate the prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with localized primary gastrointestinal stromal tumors (GISTs) and to compare the predictive values of 18F-FDG PET/CT parameters with those of clinicopathological prognostic factors. Sixty-two localized GIST patients who underwent staging with 18F-FDG PET/CT from January 2007 to December 2013 before surgery were retrospectively enrolled. A volume of interest with a standardized uptake value (SUV) threshold of 2.5 was used to determine the metabolic tumor volume (MTV) and total lesion glycolysis (TLG). These metabolic indices, along with the maximum SUV (SUVmax), were analyzed to evaluate recurrence-free survival (RFS). Other significant clinical and pathologic indices were also retrospectively reviewed for RFS analysis. Patients were followed up for a median of 42.0 months (range, 5.6–111.5). During the follow-up period, 13 patients (21.0%) experienced disease recurrence. In univariate analysis, tumor size (> 5 cm), mitotic count (> 5/high-power field), modified National Institutes of Health (NIH) consensus criteria, adjuvant imatinib treatment, SUVmax (≥ 7.04), MTV (≥ 50.76 cm3), and TLG (≥ 228.79 g) were significant prognostic factors affecting RFS (p < 0.05). In multivariate analysis, only MTV (hazard ratio, 17.69; 95% confidence interval [CI], 2.03–154.17, p = 0.009) and TLG (hazard ratio, 20.48; 95% CI, 2.19–191.16, p = 0.008) were independent prognostic factors for RFS. The 5-year RFS rates were 96.4% and 96.6% in patients with a low MTV and TLG and 27.3% and 23.6% in patients with a high MTV and TLG, respectively (p < 0.001). MTV and TLG are independent prognostic factors for predicting recurrence in patients with localized primary GIST. Patients with a high MTV or TLG are at risk for poor prognosis and should be closely observed for disease recurrence.

中文翻译：

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代谢性肿瘤体积和总病变糖酵解对局限性原发性胃肠道间质瘤患者术前¹⁸ F-FDG PET / CT的预后价值

本研究旨在评估18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET / CT）对局灶性原发性胃肠道间质瘤（GIST）患者的预后价值，并比较18F-FDG PET / CT参数与临床病理预后因素有关。回顾性分析了2007年1月至2013年12月接受18F-FDG PET / CT分期的62例局部GIST患者。标准摄取值（SUV）阈值为2.5的目标体积用于确定代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。分析这些代谢指标以及最大SUV（SUVmax），以评估无复发生存期（RFS）。其他重要的临床和病理指标也进行了回顾性分析，以进行RFS分析。对患者进行了平均42.0个月的随访（范围5.6-111.5）。在随访期间，有13名患者（21.0％）经历了疾病复发。在单变量分析中，肿瘤大小（> 5 cm），有丝分裂计数（> 5 /高倍视野），改良的美国国立卫生研究院（NIH）共识标准，伊马替尼辅助治疗，SUVmax（≥7.04），MTV（≥50.76 cm3 ）和TLG（≥228.79 g）是影响RFS的重要预后因素（p <0.05）。在多变量分析中，只有MTV（危险比为17.69； 95％置信区间[CI]为2.03–154.17，p = 0.009）和TLG（危险比为20.48； 95％CI为2.19–191.16，p = 0.008）是独立的RFS的预后因素。5年RFS率为96.4％和96。MTV和TLG较低的患者分别为6％和MTV和TLG高的患者分别为27.3％和23.6％（p <0.001）。MTV和TLG是预测局部原发GIST患者复发的独立预后因素。MTV或TLG高的患者有预后不良的风险，应密切观察其疾病复发。