基线18F-FDG PET/CT图像参数对非小细胞肺癌患者治疗后远处转移的预测价值研究OACSTPCD

Objective:This study aimed to investigate the pre-dictive value of pre-treatment 18F-FDG PET/CT for new distant me-tastases in patients with non-small cell lung cancer(NSCLC),and to provide a reference for the clinical treatment and follow-up pattern of NSCLC patients.Methods:The data from 118 patients with pathologically confirmed NSCLC who underwent 18F-FDG PET/CT at Sichuan Cancer Hospital from April 2015 to July 2021 were retrospectively analyzed,and none of these patients were found to have definite signs of distant metastasis at the time of initial diagnosis.PET metabolic parameters,CT imaging characteristics,and clinical data were analyzed using unifactorial and multifacto-rial COX regression to determine the factors predicting distant metastasis and calculate the optimal cut-off value.Results:During the two years of follow-up,a variety of distant metastases developed in 21 of 118 patients,including 8 brain metastases,7 bone metastases,4 adrenal metastases,4 lung metastases,1 liver metastases,1 pericardium metastases and 1 distant lymph node metastases.On univariate analysis,18F-FDG PET/CT parameters(SUVmax,MTV,TLG)and tumor maximum diameter(Dmax)showed significance in predicting distant metastasis(P<0.001),along with treatment,TNM stage,and presence of lymph node metastasis(P<0.05).However,multifactorial COX regression analysis showed that only maximum standardized uptake value(SUVmax)was an independent prognostic factor for new distant metastasis within two years after treatment in NSCLC patients(P = 0.018).The optimal cut-off value was 10.249(AUC = 0.811,P<0.001).Conclusion:Pre-treatment measurement of SUVmax using 18F-FDG PET/CT is an independent prognostic factor for predicting new distant metastases within a short time in NSCLC patients,which may provide valuable guidance for clinical treatment decisions and follow-up strategies.