中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (7): 505-510.doi: 10.19401/j.cnki.1007-3639.2018.07.005

• 专家述评与论著 • 上一篇    下一篇

18F-FDG PET/CT在阿帕替尼治疗肺多发转移性碘难治性分化型甲状腺癌评估中的价值

张迎强1,2,张 鑫1,2,王 宸1,2,李 慧1,2,刘延晴1,2,管文敏3,王 雷3,林岩松1,2   

  1. 1. 中国医学科学院北京协和医学院北京协和医院核医学科,北京 100730 ;
    2. 核医学分子靶向诊疗北京市重点实验室,北京 100730 ;
    3. 中国医学科学院北京协和医学院北京协和医院放射科,北京 100730
  • 出版日期:2018-07-30 发布日期:2018-08-10
  • 通信作者: 林岩松 E-mail: linys@pumch.cn
  • 基金资助:
    国家自然科学基金(81571717,81771875);中国医学科学院医学与健康科技创新工程(2016-I2M-2-006)。

The value of 18F-FDG PET/CT in the evaluation of multiple lung metastatic radioactive iodinerefractory differentiated thyroid cancer after apatinib therapy

ZHANG Yingqiang1,2, ZHANG Xin1,2, WANG Chen1,2, LI Hui1,2, LIU Yanqing1,2, GUAN Wenmin3, WANG Lei3, LIN Yansong1,2   

  1. 1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China; 2. Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China; 3. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Published:2018-07-30 Online:2018-08-10
  • Contact: LIN Yansong E-mail: linys@pumch.cn

摘要: 背景与目的:碘难治性分化型甲状腺癌(radioactive iodine-refractory differentiated thyroid cancer,RAIR-DTC)是近年来研究的热点。因肿瘤细胞的异质性,不同病灶的生长速度及治疗疗效不尽相同。该研究探讨18F-FDG PET/CT在RAIR-DTC多发肺转移患者经阿帕替尼治疗效果评估中的价值。方法:纳入于中国医学科学院北京协和医学院北京协和医院经阿帕替尼治疗的RAIRDTC患者。入组患者于基线、治疗后4周及8周行CT及18F-FDG PET/CT检查。结果:共7例患者,49个肺转移灶,SUVmax在基线时为0.8~23.2。基线时病灶的SUVmax水平与治疗后4周及8周的SUVmax变化(SUVmax-4w/SUVmax-baseline,SUVmax-8w/SUVmax-baseline)显著相关(P<0.000 1,P<0.000 1)。4周及8周的病灶直径变化率(CT4w/b,CT8w/b)与基线SUVmax无明显线性相关(P=0.666 4,P=0.478 7)。而4周的SUVmax变化(SUVmax-4w/SUVmax-baseline)与CT4w/b及CT8w/b显著相关(P=0.033 3,P=0.004 8)。对于基线水平SUVmax大于5的病灶,SUVmax-baseline与CT4w/b、CT8w/b均具有线性关系(P=0.008 2,P=0.016 9)。结论:18F-FDG PET/CT在RAIR-DTC多发肺转移患者靶向药物治疗中具有广阔的应用前景,可以识别肿瘤一致性,辅助选取靶病灶,并通过病灶的SUVmax预测患者对靶向药物治疗的疗效。

关键词: 碘难治性分化型甲状腺癌, 18F-FDG PET/CT, 阿帕替尼, 疗效评估

Abstract: Background and purpose: Radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC) is a hot topic in recent years. The growth rates of different lesions and their responses to treatment vary a lot due to the heterogeneity of tumor cells. This study aimed to explore the value of 18F-FDG PET/CT in RAIR-DTC after the therapy of apatinib. Methods: RAIR-DTC patients undergoing apatinib therapy in Peking Union Medical College Hospital were enrolled. 18F-FDG PET/CT was performed at baseline, 4 weeks and 8 weeks after apatinib therapy. Results: A total of 7 patients including 49 lung metastases were analyzed after apatinib therapy, with SUVmax varying from 0.8 to 23.2. The results showed that the SUVmax level of lesions at baseline was significantly associated with the changes in SUVmax at 4 and 8 weeks after the treatment (SUVmax-4w/SUVmax-baseline, SUVmax-8w/SUVmax-baseline) (P<0.000 1, P<0.000 1). The rate of lesion diameter change (CT4w/b, CT8w/b) was not correlated with baseline SUVmax at 4 weeks and 8 weeks (P=0.666 4, P=0.478 7). The 4-week change in SUVmax (SUVmax-4w/SUVmax-baseline) was significantly associated with CT4w/b and CT8w/b (P=0.033 3, P=0.004 8). For lesions with baseline SUVmax greater than 5, SUVmax-baseline had a linear relationship with CT4w/b and CT8w/b (P=0.008 2, P=0.016 9). Conclusion: 18F-FDG PET/CT has great value in evaluating the heterogeneity, selecting target lesions and predicting the response in patients with RAIR-DTC after apatinib therapy.

Key words: Radioactive iodine-refractory differentiated thyroid cancer, 18F-FDG PET/CT, Apatinib, Efficacy evaluation