| Objective:The purpose of this study was to analyze the prognostic value of 18F-FDG PET/CT images,metabolic parameters with nasopharyngeal carcinoma patients follow-up.Analyzing the diagnostic efficacy of 18F-FDG PET/CT metabolic parameters in differential diagnosis of nasopharyngeal carcinoma and nasopharyngea lymphoma.Methods: We analyzed PET/CT scans of 122 nasopharyngeal lymphoma and 102 nasopharyngeal carcinoma from October 2008 to December 2016,all patients didn’t undergo any treatment and nasopharyngeal biopsy before examination.All patients were recruited with the original image data,and using the PET VCAR software on the AW4.6 workstation to measure the SUVmax,SUVpeak,MTV,and TLG,the way to delineate the ROI was 42% SUVmax threshold.(1)To evaluate the clinical value of SUVmax,SUVpeak,MTV and TLG in the differential diagnosis of nasopharyngealcarcinoma and nasopharyngeal malignant lymphoma by T test.(2)Patients with nasopharyngeal lymphoma were divided into NK / T cell lymphoma,diffuse large B cell lymphoma and other types of lymphoma according to pathology.Patients with nasopharyngeal carcinoma were divided into squamous cell carcinoma and non-squamous cell carcinoma according to pathology.To evaluate the value of each parameter in the differential diagnosis of malignant lymphoma of different nasopharynx and nasopharyngeal carcinoma.The variance analysis was performed for each index,and the SNK method was used to compare the two groups.(3)We analyzed PET/CT scans of 102 considered nasopharyngeal carcinoma from October2008 to June 2016.All patients were followed up(> 6 months),rsruited the original image data of the patients who pathological diagnosis was nasopharyngeal carcinoma,and measured the metabolic parameters.The positive rate of nasopharyngeal carcinoma was examined by 18F-FDG PET/CT.The value of each factor Kaplan-Meier test was used to evaluate the prognosis.The factors influencing the progression-free survival were analyzed by multivariate COX regression analysis.Results:(1)In patients with nasopharyngeal malignancies,there was no significant difference in SUVmax(p = 0.09),SUVpeak(p = 0.129)and TLG(p = 0.061) between nasopharyngeal carcinoma and nasopharyngeal malignant lymphoma.MTV values were higher than those in nasopharyngeal carcinoma group and were statistically significant(p = 0.029).According to the median MTV level,the two groups of patients were divided into low level group and high level group.Among them,the TLG value of nasopharyngeal lymphoma was higher than that of nasopharyngeal carcinoma in high level group(p = 0.041),in the MTV low level group,TLG has no significant difference.(2)In patients with malignant lymphoma of nasopharynx,the SUVmax and SUVpeak in diffuse large B-cell lymphoma were higher than those in NK / T cell lymphoma(p = 0.030,p = 0.013)and other types of lymphoma(p = 0.002,p = 0.002).There was no significant difference in SUVmax and SUVpeak between NK / T cell lymphoma and other types of lymphoma(p =0.283,p = 0.459).The SUVmax of nasopharyngeal squamous cell carcinoma was higher than that of NK/ T cell type(p = 0.013)and other types of lymphoma(p =0.001).And SUVmax had no significant difference(P> 0.05)in all types of nasopharyngeal lymphoma.There was no significant difference in SUVmax and SUVpeak between nasopharyngeal non-squamous cell carcinoma and nasopharyngeal lymphoma(p> 0.05).In nasopharyngeal malignancies,there was no significant difference in MTV and TLG Between the different pathological types of nasopharyngeal lymphoma and nasopharyngeal carcinoma.(3)The positive rate of18F-FDG PET / CT in nasopharyngeal carcinoma was 98.04%(100/102).Univariate analysis showed that age(p = 0.670)and gender(p = 0.423)had no significant correlation with prognosis(p = 0.006),MTV(p = 0.046),and TLG(p = 0.004)were associated with prognosis,and TLG was an independent predictor of prognosis(p =0.040).Conclusions:(1)MTV has the application value in the differential diagnosis of nasopharyngeal carcinoma and nasopharyngeal lymphoma,when MTV at a high level,TLG has the application value.(2)SUVmax and SUVpeak can be the effective differential diagnosis factor to diffuse large B-cell lymphoma with NK / T cell lymphoma and other types of lymphoma.SUVmax can be an effective differential diagnosis factor of nasopharyngeal squamous cell carcinoma with NK / T cell lymphoma.(3)18F-FDG PET / CT had a high positive diagnostic accuracy of 98.04% for nasopharyngeal carcinoma.(4)Univariate analysis showed that clinical stage,pathological type,MTV and TLG were related to prognosis,and multivariate analysis showed that TLG was an independent predictor of prognosis. |
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