Nuklearmedizin - NuclearMedicine, Table of Contents

Nuklearmedizin 2018; 57(05): 190-197
DOI: 10.3413/Nukmed-0965-18-03

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Prognostic Value of Pre-treatment F-18 FDG PET Metabolic Metrics in Patients with Locally Advanced Carcinoma of the Anus with and without HIV Infection

Prognostischer Wert der F-18 FDG PET metabolischen Aktivität vor Therapie des lokal fortgeschrittenen Anal-Plattenepithelkarzinoms bei HIV-positiven und -negativen Patienten

Ismaheel O. Lawal

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

,

Alfred O Ankrah

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

²Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen & University of Groningen, Groningen, The Netherlands

,

Kgomotso M.G. Mokoala

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

,

Gbenga O. Popoola

³Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria

,

Chimbabantu A Kaoma

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

,

Alex Maes

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

⁴Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium

,

Neo P. Mokgoro

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

,

Christophe Van de Wiele

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

⁵Department of Radiology and Nuclear Medicine, University Ghent, Ghent, Belgium

,

Mike M. Sathekge

¹Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

› Author Affiliations

Summary

Aim: To investigate the prognostic value of F-18 FDG PET metabolic parameters in patients with anal carcinoma with and without human immunodeficiency virus infection (HIV). Methods: Maximum standardized uptake value (SUV_max), mean standardized uptake value (SUV_mean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained on F-18 FDG PET/CT images of treatment-naïve patients with locally advanced anal squamous cell carcinoma (ASSC). We compared patients’ characteristics and F-18 FDG PET metabolic metrics between the HIV-infected patients and the HIV-uninfected patients. We did a simple Cox regression analysis followed by a multiple Cox regression analysis to determine factors predictive of death. Results: We studied 33 patients including 21 HIV-infected individuals, mean age = 46.06 ± 12.59, female = 16, males = 17. Median CD4 count among HIV-infected patients was 400.50 cells/mm³ (IQR: 304.0 – 642.25). HIV-infected patients were younger than the HIV-uninfected patients at the time of diagnosis; 38.71 ± 7.98 vs. 58.92 ± 7.88 respectively, p < 0.001. No significant difference in the TNM stage and F-18 FDG metabolic parameters between the two groups. In a simple Cox regression analysis, MTV and TLG were significant predictors of death. Following a multiple Cox regression analysis, MTV and SUV_mean were significant predictors of death. The median overall survival was 44.63 (95 % CI: 34.12 – 55.14) among HIV-infected patients versus 54.65 (95 % CI: 45.73 – 63.57) among HIV-uninfected patients, p = 0.415. Conclusion: HIV-infected patients are diagnosed with ASSC at a younger age compared with HIV-uninfected patients. F-18 FDG PET metabolic metrics especially MTV predicts overall survival in patients with ASCC. There is no difference in the overall survival of HIV-infected and HIV-uninfected patients treated similarly for ASSC.

Zusammenfassung

Ziel: Die Untersuchung der prognostischen Bedeutung der F-18 FDG PET metabolischen Aktivität bei HIV-negativen und positiven Analkarzinom-Patienten. Methoden: Bestimmt wurden maximale standardisierten Uptake-Werte (SUV_max), mittlere standardisierte Uptake-Werte (SUV_mean), das metabolische Tumorvolumen (MTV) sowie die gesamte Tumorlyse-Glukose (TLG) mittels F-18 FDG PET/CT bei behandlungsnaiven Patienten mit lokal fortgeschrittenem Anal-Plattenepithelkarzinom (ASSC). Die Patientencharakteristika und F-18 FDG PET metabolischen Ergebnisse der HIV-positiven und HIV-negativen Patienten wurden verglichen. Eine einfache Cox-Regressionsanalyse gefolgt von einer multiplen Cox-Regressionsanalyse diente der Bestimmung von Faktoren für Tod.

Ergebnisse: Wir untersuchten 33 Patienten, davon 21 HIV-Infizierte, mittleres Alter = 46,06 ± 12,59, Frauen = 16, Männer = 17. Die mediane CD4-Zahl unter den HIV-Patienten war 400,50 Zellen/mm³ (IRQ: 304,0 – 642,25). Die HIV-infizierten Patienten waren jünger als die HIV-negativen Patienten zum Zeitpunkt der Diagnose; 38,71 ± 7,98 vs. 58,92 ± 7,88, p < 0,001. Es gab keinen signifikanten Unterschied in der TNM-Klassifikation und in den F-18 FDG metabolischen Werten zwischen den beiden Gruppen. In einer einfachen Cox-Regressionsanalyse waren MTV und TLG signifikante Prädiktoren für Tod. Das mediane Gersamtüberleben lag bei 44,63 (95 % CI: 34,12 – 55,14) unter den HIV-infizierten Patienten vs. 54,65 (95 % CI: 45,73 – 63,57) unter den HIV-negativen Patienten, p = 0,415.

Schlussfolgerungen: HIV-infizierte Patienten werden in jüngeren Jahren mit ASSC diagnostiziert im Vergleich zu HIV-negativen Patienten. F-18 FDG PET metabolische Aktivität, insbesondere MTV, kann das Gesamtüberleben von Patienten mit ASCC vorhersagen. Es gibt keinen Unterschied im Gesamtüberleben von HIV-infizierten und HIV-negativen Patienten bei gleicher Therapie des ASSC.

Keywords

Keywords

F-18 FDG PET - SUV_max - MTV - TLG - HIV - carcinoma of the anus

Schlüsselwörter

Schlüsselwörter

F-18 FDG PET - SUV_max - MTV - TLG - HIV - Analkarzinom

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