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Background <p>This study is to investigate the feasibility of using the <sup>18</sup>F fluorodeoxyglucose (<sup>18</sup>F-FDG) positron emission tomography / computed tomography (PET/CT) metabolic parameters to predict the MSI status of gastric cancer (GC) patients.</p> Materials and methods <p>Patients with GC who underwent <sup>18</sup>F-FDG PET/CT before surgery from January 2021 to June 2022 were retrospectively analyzed. Calculate and record the <sup>18</sup>F-FDG PET/CT metabolic parameters of primary gastric cancer lesions, including maximum, peak and average standardized uptake values (SUVmax, SUVpeak, and SUVmean), as well as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The status of MSI was determined by immunohistochemical assay. The differences of quantitative parameters between MSI and microsatellite stability (MSS) groups were evaluated, and the prediction performance of metabolic parameters was analyzed by using subject operating characteristic (ROC) analysis and area under ROC curve (AUC).</p> Results <p>62 patients (44 males and 18 females; age range 30–81 years-old, median age 65.5 years-old) were finally included. There were 20 patients in MSI group and 42 patients in MSS group. MTV<sub>30%</sub>, MTV<sub>40%</sub>, MTV<sub>50%</sub> and MTV<sub>60%</sub>, as well as TLG<sub>40%</sub> showed significant differences between the two groups (all <i>P </i>values &lt;0.05), within which MTV<sub>40%</sub> demonstrated the highest AUC value [0.825, 95% confidence interval (CI): 0.703-0.947] in predicting MSI, the cutoff value was 44.1. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy value were 66.7%, 97.6%, 86.7%, 85.1%, and 85.5%, respectively<b>. </b>In multiple logistic regression analysis, MTV<sub>40%</sub> was an important predictor of MSI.</p> Conclusion <p><sup>18</sup>F-FDG PET/CT metabolic parameters could predict the preoperative GC MSI status, and MTV<sub>40%</sub>shows the highest predictive efficiency. <sup>18</sup>F-FDG PET/CT imaging might be used as a non-invasive tool to guide the immunotherapy and individualized treatment of GC patients.</p>

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Predictive value of 18F-FDG PET/CT metabolic parameters for gastric cancer patients’ microsatellite instability status

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Bangyu Liang,
  • Ziyue Na,
  • Kezheng Wang

摘要

Background

This study is to investigate the feasibility of using the 18F fluorodeoxyglucose (18F-FDG) positron emission tomography / computed tomography (PET/CT) metabolic parameters to predict the MSI status of gastric cancer (GC) patients.

Materials and methods

Patients with GC who underwent 18F-FDG PET/CT before surgery from January 2021 to June 2022 were retrospectively analyzed. Calculate and record the 18F-FDG PET/CT metabolic parameters of primary gastric cancer lesions, including maximum, peak and average standardized uptake values (SUVmax, SUVpeak, and SUVmean), as well as metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The status of MSI was determined by immunohistochemical assay. The differences of quantitative parameters between MSI and microsatellite stability (MSS) groups were evaluated, and the prediction performance of metabolic parameters was analyzed by using subject operating characteristic (ROC) analysis and area under ROC curve (AUC).

Results

62 patients (44 males and 18 females; age range 30–81 years-old, median age 65.5 years-old) were finally included. There were 20 patients in MSI group and 42 patients in MSS group. MTV30%, MTV40%, MTV50% and MTV60%, as well as TLG40% showed significant differences between the two groups (all P values <0.05), within which MTV40% demonstrated the highest AUC value [0.825, 95% confidence interval (CI): 0.703-0.947] in predicting MSI, the cutoff value was 44.1. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy value were 66.7%, 97.6%, 86.7%, 85.1%, and 85.5%, respectively. In multiple logistic regression analysis, MTV40% was an important predictor of MSI.

Conclusion

18F-FDG PET/CT metabolic parameters could predict the preoperative GC MSI status, and MTV40%shows the highest predictive efficiency. 18F-FDG PET/CT imaging might be used as a non-invasive tool to guide the immunotherapy and individualized treatment of GC patients.