Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

Abstract

Purpose This study aimed to further stratify prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Materials and MethodsThe subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F-18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were measured by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival curves were used for evaluation of progression-free survival (PFS). The univariate and multivariate Cox proportional hazards models were used to select the significant prognostic factors. Results Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV-lung and TLG-lung) were significant factors for prediction of PFS (P<0.001, P00.038, respectively). Patients showing lower values of MTV-lung and TLG-lung than the cutoff values had significantly longer mean PFS than those with higher values. Hazard ratios (95 % confidence interval) of MTV-lung and

Total lesion glycolysis by 18F‐FDG PET/CT is independent prognostic factor in patients with advanced non‐small cell lung cancer

“…Both successfully classified patients with better prognosis. Similar to our findings Yoo et al (42) study pointed out that clinical parameters such as age, sex, histology of tumor, ECOG performans score and SUVmax did not show any significance. Our results are consistent with those of other studies that have reported that TLG and MTV are better predictors of patients survival than SUVmax or SUVmean in advanced stage NSCLC (43)(44)(45).…”

Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging

“…Therefore, the FDG PET/CT scanners used in the study and clinical variables in the modeling and validation cohorts mimic real world situations, suggesting that the MTVwb risk stratification system developed and validated in this study may be generalizable to other centers. There are other reasons to expect that the MTVwb risk stratification system can be used in other centers and be practical in clinical use including: 1) measurement of MTVwb is practical with commercially available software, and semi-automatic tumor segmentation is as accurate as manual segmentation for primary NSCLC tumors [25]; 2) MTVwb estimates are relatively insensitive to different FDG PET/CT scanners and image-reconstruction algorithms [26]; 3) a number of studies have demonstrated consistently significant correlation between survival and MTVwb in NSCLC, in different parts of the world, and with different FDG PET/CT scanners[2–11, 13, 14, 27–31], 4) the variability of metabolic tumor volume in NSCLC primary tumors is less than that of SUV for NSCLC primary tumor in PET scans of 1-hour vs. 2-hour FDG uptake time [32]; and 5) MTVwb measurements are relatively immune to inter-observer variability[2, 5]. …”

Prognostic Value of Metabolic Parameters in Patients with Synchronous Colorectal Cancer Liver Metastasis Following Curative-Intent Colorectal and Hepatic Surgery

“…This underscores the need for a new prognostic model that uses biologic and clinicopathologic factors to guide treatment of the patients with SCLM (11,12). 18 F-FDG PET/CT uses the increased rates of glucose metabolism in tumors to characterize the biology of different cancers, with several studies having reported that high rates of 18 F-FDG uptake in tumors are associated with increased aggressiveness and poor survival (13,14). However, only a limited number of studies have addressed the prognostic ability of 18 F-FDG PET/CT in patients with CRC liver metastasis (15)(16)(17).…”