The aim of the present study was to investigate the prognostic value of quantitative [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) parameters for patients with non-small cell lung cancer (NSCLC). The present study conducted a retrospective review of the medical records of 203 patients with NSCLC, of which 193 patients underwent baseline 18F-FDG PET/CT prior to initial therapy. Multivariate analyses using Cox's proportional hazards regression were performed for the assessment of the association between initial PET/CT measurements and overall survival (OS). The multivariate models were adjusted for sex, age, smoking status, disease stage, standardized uptake value (SUV), standardized uptake value corrected for lean body mass (SUL), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and standard deviation of SUV (SD). Kaplan-Meier (K-M) estimator curves were constructed following the formation of three approximately equal-sized groups using tertiles for each PET/CT measurement (n=65, 64 and 64). OS curves were plotted using K-M estimator curves. Results demonstrated significant associations between OS and MTVPET volume computerized assisted reporting (PETVCAR), MTV2.5, MTV25%, MTV42% and TLGPETVCAR; however, no significant associations were identified between OS and MTV50%, MTV75%, TLG2.5, all SUV and SUL. Subgroup analyses according to pathology demonstrated that there were statistically significant associations between OS and stage (P<0.001), MTV50% (P=0.002) and MTV42% (P=0.004) in the adenocarcinoma group, and SULmean (P=0.010), MTV25% (P=0.005) and MTV42% (P=0.001) in the squamous cell carcinoma group; however, no significant differences were identified between any other group. Furthermore, there was a significant association between OS and MTV42% (P=0.02) and MTV50% (P=0.04) in the early-stage group; however, no significant differences were identified in the advanced-stage group. K-M estimator curve analyses demonstrated that the pathology (P=0.01), stage (P<0.001) and all PET metabolic parameters with the exception of SD were significantly associated with OS (P<0.05). No significant associations were demonstrated between SD and OS. In conclusion, 18F-FDG PET/CT MTVPETVCAR, MTV2.5, MTV25%, MTV42% and TLGPETVCAR exhibit prognostic values with regard to OS. Overall, selection of appropriate metabolic parameters may predict NSCLC prognosis.

Background: This retrospective study was performed to estimate the clinical role of whole-body positron emission tomography/computed tomography (PET/CT) using 2-[ 18 F] fluoro-2-deoxy-D-glucose (FDG) in the differential diagnosis of primary benign and malignant unilateral adrenal tumors. Methods: A total of 64 patients (31 male, 33 female; age range: 3-76 years, mean: 48.5) with a confirmed unilateral adrenal tumor underwent 18 F-FDG PET/CT examination for diagnosis and staging. The whole-body 18 F-FDG PET/CT examination excluded metastasis, and all patients were confirmed by operation and biopsy pathology. Their clinical data and pathological results were collected. On visual analysis of PET/CT imaging, adrenal uptake was based on a three-scale grading system. The region of interest (ROI) was delineated in the liver and the renal lesion site. Standardized uptake value (SUV) measurements were determined on a standardized reconstruction, and the maximum values (SUV max ) of the lesion and liver were measured. The ratio of tumor to the liver was defined as T/L. Visual interpretation, SUV max -receiver operating characteristics (ROC) method, and T/L-ROC method were used to analyze the diagnostic accuracy.Results: A total of 64 lesions (48 benign, 16 malignant lesions) were detected. The visual analysis found that 100% of Grade I cases were benign, 90.9% of Grade II cases were benign, and 65.1% of Grade III cases were benign. The SUV max of malignant lesions (10.0±5.8) was higher than that of benign lesions (5.4±5.3, P<0.05). The T/L was 3.39±1.79 for malignant lesions and 1.99±2.09 for benign lesions (P<0.05). In the differentiation of primary benign and malignant unilateral adrenal tumors, the sensitivity, specificity, and accuracy of the SUV max -ROC method (cut-off value =5.65) were 81.25%, 72.91%, 75.00%, and the positive and negative predictive values were 50.00% and 92.11%, respectively. The sensitivity, specificity, and accuracy of the T/L-ROC method (cut-off value =1.52) were 93.73%, 62.50%, 70.31%, and the positive and negative predictive values were 46.88% and 96.77%, respectively.Conclusions: 18 F-FDG PET/CT improved diagnostic accuracy in differentiating primary benign and malignant unilateral adrenal tumors. There was a high negative predictive value, and for positive prediction, other tracer imaging is needed for differential diagnosis.