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Usefulness of 18F-FDG PET/CT in treatment-naive patients with thymic squamous cell carcinoma

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Abstract

Objective

Thymic squamous cell carcinoma (TSCC) is very rare. This study aims to investigate the clinical utility of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in treatment-naive patients with TSCC.

Methods

The tumor metabolic parameters of 18F-FDG PET/CT, including maximum standard uptake value (SUVmax), metabolic tumor volume of primary lesion (MTV-P) and combination of primary lesion and metastases (MTV-C), and total lesion glycolysis of primary lesion (TLG-P) and combination of primary lesion and metastases (TLG-C) were collected. Age, sex, smoking, serum tumor markers, tumor size, Masaoka-Koga stage, TNM stage, contrast-enhanced CT scan, and tumor immunity were also reviewed. Moreover, progression-free survival (PFS) and overall survival (OS) of these patients were analyzed.

Results

Forty-two treatment-naive patients with TSCC were enrolled in this study. All primary tumors were FDG-avid with the average SUVmax of 10.0 ± 4.5 (range, 1.5–20.4). Higher SUVmax, MTV-C, and TLG-C were observed in advanced Masaoka-Koga stage than early stage, and higher SUVmax was found in advanced TNM stage than early stage. Next, 36 out of 42 patients performed chest contrast-enhanced CT scan, which showed SUVmax associated with the enhancement degree of CT. Moreover, 27 out of 42 lesions were assessed tumor immunity, and the detective rates of PD-L1, PD-1, CD4, CD8, and Foxp3 were 59.3%, 37.0%, 59.3%, 100%, and 77.8%, respectively. Higher SUVmax was observed in lesions with lower CD4-positive tumor-infiltrating lymphocytes. Furthermore, 12- and 24-month PFS and OS rates were 62.0% vs 32.8% and 84.5% vs 68.9%, respectively. Multivariate Cox regression analysis showed that only MTV-C was an independent predictor of PFS.

Conclusion

18F-FDG PET/CT is useful in evaluating tumor staging, assessing CT enhancement degree, and detecting tumor immunity of TSCC before treatment. 18F-FDG PET/CT could also be a promising tool to provide prognostic information for treatment-naive patients with TSCC.

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Acknowledgements

This work was supported by funds from the National Natural Science Foundation of China (81971645).

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Author notes

  1. Yuan Li, Yi Li and Yan Huang contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China

    Yuan Li, Yi Li, Xiaodong Wu, Zi Yang & Lei Jiang

  2. Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China

    Yan Huang & Chunyan Wu

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  1. Yuan Li
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Supplementary Information

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12149_2021_1640_MOESM1_ESM.tif

Supplementary file 1. (TIF 1378 KB). Figure 1. The Kaplan-Meier curve of PFS (a) and OS (b) in 8 patients treated with operation alone, respectively

12149_2021_1640_MOESM2_ESM.docx

Supplementary file 2. (DOCX 20 KB). Table 1. Univariate cox proportional hazards regression for PFS and OS in 35 patients with contrast-enhanced CT

12149_2021_1640_MOESM3_ESM.docx

Supplementary file 3. (DOCX 21 KB). Table 2. Univariate cox proportional hazards regression for PFS and OS in 27 patients with tumor immunity analysis

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Li, Y., Li, Y., Huang, Y. et al. Usefulness of 18F-FDG PET/CT in treatment-naive patients with thymic squamous cell carcinoma. Ann Nucl Med 35, 1048–1057 (2021). https://doi.org/10.1007/s12149-021-01640-5

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  • DOI: https://doi.org/10.1007/s12149-021-01640-5

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