Molecular imaging and biology · 2026
Value of Imaging Parameters of [18F]FDG PET/CT and Serological Indices in Predicting Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma.
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Yan Yihan, Pang Lifang, He Yibo, Jiang Zhenghao, Zhang Yiqiu
Аннотация
OBJECTIVE: This study aimed to evaluate the value of [18F]FDG PET/CT parameters and serological indices in predicting lymph node metastasis (LNM) in patients with intrahepatic cholangiocarcinoma (ICC) preoperatively.
METHODS: The study included 102 patients with ICC diagnosed between January 2018 and December 2022. All patients underwent preoperative [18F]FDG PET/CT scanning and serological marker evaluations before surgical tumor resection. The [18F]FDG PET/CT scanning was jointly evaluated by two nuclear medicine physicians blinded to the clinical information and compared with postoperative pathologic results. The tumor SUVmax, tumor-to-background ratios (TBR), SUVpeak, and total lesion glycolysis (TLG) were obtained from the PET/CT scans. Presurgical serological testing included carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The results were analyzed by bivariate and multivariate logistic regression to develop a prediction model for LNM.
RESULTS: Among the 102 patients with ICC, 60 (58.8%) patients had LNM while 42 patients (41.2%) were free of LNM. TBR(without LNM: 6.9 ± 3.6 vs. LNM: 8.2 ± 2.9, P = 0.019), CA19-9(506.9 ± 1602.7 vs. 1901.2 ± 3195.1, P = 0.011) and CEA(5.1 ± 8.9 vs. 32.5 ± 82.7, P = 0.035) in the LNM group were significantly higher than in the without LNM group. Three additional, statistically significant features, tumor TBR > 6.4, CA19-9 > 149.7 U/mL and CEA > 3.2 ng/mL, were integrated into a prediction model, which substantially outperformed use of the single parameter in ROC analysis (AUC 0.802 vs. 0.676, 0.671 and 0.656).
CONCLUSION: TBR > 6.4 and CA19-9 > 149.7 U/mL were identified as effective preoperative predictors of LNM in patients with ICC. The prognostic model we propose, integrating imaging parameters and serological indicators, significantly enhances predictive capability.
METHODS: The study included 102 patients with ICC diagnosed between January 2018 and December 2022. All patients underwent preoperative [18F]FDG PET/CT scanning and serological marker evaluations before surgical tumor resection. The [18F]FDG PET/CT scanning was jointly evaluated by two nuclear medicine physicians blinded to the clinical information and compared with postoperative pathologic results. The tumor SUVmax, tumor-to-background ratios (TBR), SUVpeak, and total lesion glycolysis (TLG) were obtained from the PET/CT scans. Presurgical serological testing included carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). The results were analyzed by bivariate and multivariate logistic regression to develop a prediction model for LNM.
RESULTS: Among the 102 patients with ICC, 60 (58.8%) patients had LNM while 42 patients (41.2%) were free of LNM. TBR(without LNM: 6.9 ± 3.6 vs. LNM: 8.2 ± 2.9, P = 0.019), CA19-9(506.9 ± 1602.7 vs. 1901.2 ± 3195.1, P = 0.011) and CEA(5.1 ± 8.9 vs. 32.5 ± 82.7, P = 0.035) in the LNM group were significantly higher than in the without LNM group. Three additional, statistically significant features, tumor TBR > 6.4, CA19-9 > 149.7 U/mL and CEA > 3.2 ng/mL, were integrated into a prediction model, which substantially outperformed use of the single parameter in ROC analysis (AUC 0.802 vs. 0.676, 0.671 and 0.656).
CONCLUSION: TBR > 6.4 and CA19-9 > 149.7 U/mL were identified as effective preoperative predictors of LNM in patients with ICC. The prognostic model we propose, integrating imaging parameters and serological indicators, significantly enhances predictive capability.