基于18F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测

目的 本研究将探讨基于氟-18-脱氧葡萄糖(¹⁸F-fluorodeoxyglucose,¹⁸F-FDG)正电子发射型计算机断层显像/电子计算机断层显像(positron emission tomography/computed tomography,PET/CT) 的改良PET-腹膜癌指数(peritoneal cancer index,PCI)、最大标准化摄取值(maximum standardized uptake value,SUVmax)与最大标准化摄取值/肝脏平均标准化摄取值(SUVmax/ liver mean standardized uptake value, SUVmax/SUVmean_liver)预测腹膜假黏液瘤(pseudomyxoma peritonei,PMP)组织病理学分级的能力。 方法 回顾性分析2017年1月至2022年6月间31例阑尾来源PMP患者的临床病理学数据及34例次(3名患者行2次检查)¹⁸F-FDG PET/CT检查结果。将13个特定腹盆区域PMP病灶的SUVmax评分汇总得到PET-PCI。同时还测量了腹盆腔病灶的SUVmax与SUVmax/SUVmean_liver。 结果 低级别PMP患者14例、高级别PMP患者12例、高级别伴印戒细胞PMP患者5例。高级别PMP患者的PET-PCI、SUVmax和SUVmax/SUVmean_liver值均高于低级别PMP患者(PET-PCI: 23.08±7.47 vs 15.81±10.59,P=0.047; SUVmax:7.91±4.67 vs 6.73±3.99,P=0.470;SUVmax/SUVmean_liver:3.63±1.89 vs 3.17±2.70,P=0.614)。高级别伴印戒细胞PMP患者的 PET-PCI、SUVmax及SUVmax/SUVmean_liver值均高于高级别PMP患者(PET-PCI:25.20±8.84 vs 23.08±7.47,P=0.614; SUVmax:9.29±8.46 vs 7.91±4.67,P=0.660;SUVmax/SUVmean_liver:3.73±1.83 vs 3.63±1.89,P=0.917)。PET-PCI、SUVmax及SUVmax/SUVmean_liver值的高低与PMP分级一致,但只有高级别PMP患者的PET-PCI与低级别PMP患者之间的差异有统计学意义。 结论 与SUVmax及SUVmax/SUVmean_liver相比,PET-PCI能更好地反映PMP患者的组织病理学分级。

Prediction of tumor histopathological grade using a modified peritoneal cancer index by 18F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei

Objective The aim of this study was to investigate the ability of the modified peritoneal cancer index (PCI) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT), maximum standardized uptake value (SUVmax) and SUVmax/liver mean standardized uptake value(SUVmean_liver) to predict the histopathological grade in patients with pseudomyxoma peritonei(PMP). Methods The pathological data of 31 patients with PMP of appendiceal origin and 34 ¹⁸F-FDG PET/CT results (3 patients underwent twice examinations) from January 2017 to June 2022 were analyzed retrospectively. PET-PCI was the sum of the SUVmax scores of PMP lesions in 13 specific abdominal-pelvic regions. The SUVmax and SUVmax/SUVmean_liver of the lesion were also measured. Results There were 14 cases of low grade PMP, 12 cases of high grade PMP, and 5 cases of high grade with signet ring cells PMP. The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade were higher than those of the low grade (PET-PCI:23.08 ± 7.47 vs 15.81 ± 10.59, P=0.047; SUVmax:7.91 ± 4.67 vs 6.73 ± 3.99, P=0.470; SUVmax/SUVmean_liver:3.63 ± 1.89 vs 3.17 ± 2.70, P=0.614). The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade with signet ring cells were higher than those of the high grade (PET-PCI:25.20 ± 8.84 vs 23.08 ± 7.47, P=0.614; SUVmax:9.29 ± 8.46 vs 7.91 ± 4.67, P=0.660;SUVmax/SUVmean_liver:3.73±1.83 vs 3.63±1.89,P=0.917)。The values of PET-PCI, SUVmax, and SUVmax/SUVmean_liver were consistent with the PMP histopathological grade, while there was only a significant different between the PET-PCI of the high-and low-grade PMP. Conclusion Compared with SUVmax and SUVmax/SUVmean_liver, PET-PCI can better reflect the histopathological grade of PMP.