대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제80권6호
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  • Pages.1132-1144
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  • 2019
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  • 1738-2637(pISSN)
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  • 2288-2928(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

악성 흑색종 환자에서 시행한 F-18 Fluorodeoxyglucose PET/CT의 지방 조직 및 골수의 영상 파라메터들이 예후에 미치는 영향 평가

Prognostic Significance of the Imaging Parameters of Adipose Tissue and Bone Marrow on F-18 Fluorodeoxyglucose PET/CT in Patients with Malignant Melanoma

  • 이주하 (순천향대학교 천안병원 영상의학과) ;
  • 이상미 (순천향대학교 천안병원 핵의학과) ;
  • 김정은 (순천향대학교 천안병원 피부과)
  • Lee, Ju Ha (Department of Radiology, Soonchunhyang University Cheonan Hospital) ;
  • Lee, Sang Mi (Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Jung Eun (Department of Dermatology, Soonchunhyang University Cheonan Hospital)
  • 투고 : 2018.12.18
  • 심사 : 2019.06.06
  • 발행 : 2019.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적 골수와 지방 조직의 F-18 Fluorodeoxyglucose (이하 F-18 FDG) 섭취는 악성 종양에 대한 전신 염증을 반영한다고 알려져 있다. 본 연구는 악성 흑색종에서 F-18 FDG PET/CT상 골수의 FDG 섭취와 내장 및 피하 지방 조직의 특성이 가지는 예후적 가치에 대해 평가하였다. 대상과 방법 병리학적으로 악성 흑색종으로 진단받은 환자 중 FDG PET/CT를 시행한 33명의 환자들을 진료차트를 분석하여 후향적으로 포함하였다. 골수 대 간의 FDG 섭취 비, 부피, CT Hounsfield unit (이하 HU) 및 FDG PET/CT상 내장 및 피하 지방 조직의 mean standardized uptake value (이하 SUVmean)을 측정하고, 이 매개 변수들을 가지고 질병 무진행 생존율에 미치는 예후적 가치에 대해 평가하였다. 결과 병기 III~IV의 환자는 병기 I~II의 환자에 비해 내장 및 피하 지방 조직의 CT HU 및 SUVmean 정도가 더 높았으며, 내장 지방 조직의 부피는 더 적었다(p < 0.05). 생존 분석에서 내장 및 피하 지방 조직의 CT HU와 SUVmean, 그리고 골수 대 간 섭취 비는 악성 흑색종의 무진행 생존율과 의미 있는 관련성을 보였는데(p < 0.05), 두 지방 조직의 CT HU 및 SUVmean이 높을수록, 골수 대 간 섭취 비가 높을수록 더 안 좋은 생존율을 보였다. 반면, 두 지방 조직의 부피는 악성 흑색종의 무진행 생존율과 유의한 연관성을 보이지 않았다(p > 0.05). 결론 내장 및 피하 지방 조직의 CT HU 및 SUVmean, 골수의 SUVmean은 악성 흑색종에서 무진행 생존율을 예측할 수 있는 예후적 정보를 제공할 수 있다.

Purpose Fluorodeoxyglucose (FDG) uptake of bone marrow (BM) and adipose tissue is known to reflect systemic inflammatory response to cancer cell. The objective of this study was to evaluate the prognostic value of F-18 FDG uptake of BM and determine characteristics of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) on PET/CT images in malignant melanoma. Materials and Methods We retrospectively reviewed 33 patients histopathologically diagnosed with malignant melanoma via FDG PET/CT staging. BM-to-liver uptake ratio (BLR), volume of VAT and SAT, CT Hounsfield unit (HU), and mean of standardized uptake value (SUVmean) of VAT and SAT on PET/CT were measured and prognostic values of these parameters for prediction of disease progression-free survival (DPFS) were evaluated. Results Patients with stage III-IV melanoma had higher CT HU and SUVmean for SAT and VAT but lower volume of VAT compared with patients at stage I-II (p < 0.05). Survival analysis, patients with high CT HU of VAT and SAT, high SUVmean of VAT and SAT, and high BLR showed worse DPFS (all p < 0.05), indicating significant association. However, volume of SAT or VAT failed to show significant association with DPFS (p > 0.05). Conclusion CT HU, SUVmean of SAT and VAT, and BLR provide prognostic information for DPFS in malignant melanoma.

키워드

과제정보

This work was supported by Soonchunhyang University Research Fund and the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: NRF-2018R1C1B5040061).

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