本研究的目的是[1]通过18F-FDGPET/CT表征Erdheim-Chester病(ECD)的分布,[2]确定代谢(18F-FDGPET/CT)成像与解剖成像(CT或MRI)在评估ECD患者的临床试验资格中的实用性。
对纳入前瞻性登记研究的ECD患者的18F-FDGPET/CT和相应的CT或MRI研究进行综述。疾病部位被归类为[1]仅可通过18F-FDGPET检测到,仅CT/MRI,或两者兼有,并且作为[2]仅可由修改的PERCIST(MPRCIST)测量,只有RECIST,或者两者兼而有之。进行描述性分析和配对t检验进行组间比较。
纳入50名患者(平均年龄51.5岁;范围18-70岁)。在所有成像方式中检测到333个疾病部位,18F-FDGPET和CT/MRI检查结果为188(56%),67(20%),仅18F-FDGPET,75(23%)仅通过MRI大脑,和3(1%)仅通过CT。在通过mPERCIST或RECIST可测量的178个疾病部位中,40(22%)可以用这两个标准来衡量,136(76%)仅按MPRCIST计算,和2(1%)仅由RECIST。在病人层面上,17人(34%)患有mPERCIST和RECIST可测量的疾病,30(60%)只患有mPERCIST可测量的疾病,0例仅有RECIST可测量的疾病(p<0.0001)。
与解剖成像相比,18F-FDGPET/CT增强了对ECD疾病程度的评估,并增加了通过正式响应标准可测量的疾病部位的识别,因此符合临床试验的资格。互补的器官特异性解剖成像提供了以更大的解剖细节表征疾病部位的能力。
ClinicalTrials.gov标识符:NCT03329274。
The aim of this
study was to [1] characterize distribution of Erdheim-Chester Disease (
ECD) by 18F-FDG PET/CT and [2] determine the utility of metabolic (18F-FDG PET/CT) imaging versus anatomic imaging (CT or MRI) in evaluating
ECD patients for clinical
trial eligibility.
18F-FDG PET/CT and corresponding CT or MRI studies for
ECD patients enrolled in a prospective registry
study were reviewed. Sites of disease were classified as [1] detectable by 18F-FDG PET only, CT/MRI only, or both and as [2] measurable by modified PERCIST (mPERCIST) only, RECIST only, or both. Descriptive analysis was performed and paired t test for between-group comparisons.
Fifty patients were included (mean age 51.5 years; range 18-70 years). Three hundred thirty-three disease sites were detected among all imaging modalities, 188 (56%) by both 18F-FDG PET and CT/MRI, 67 (20%) by 18F-FDG PET only, 75 (23%) by MRI brain only, and 3 (1%) by CT only. Of 178 disease sites measurable by mPERCIST or RECIST, 40 (22%) were measurable by both criteria, 136 (76%) by mPERCIST only, and 2 (1%) by RECIST only. On the patient level, 17 (34%) had mPERCIST and RECIST measurable disease, 30 (60%) had mPERCIST measurable disease only, and 0 had RECIST measurable disease only (p < 0.0001).
Compared with anatomic imaging, 18F-FDG PET/CT augments evaluation of disease extent in ECD and increases identification of disease sites measurable by formal response criteria and therefore eligibility for clinical trials. Complementary organ-specific anatomic imaging offers the capacity to characterize sites of disease in greater anatomic detail.
ClinicalTrials.gov Identifier: NCT03329274.