The Value of the Standardized Uptake Value (SUV) and Metabolic Tumor Volume (MTV) in Lung Cancer

Hicks, Rodney J.

doi:10.1053/j.semnuclmed.2022.04.007

Cited by 17 publications

(7 citation statements)

References 70 publications

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“…The role of [ 18 F]FDG-PET/CT both in the characterization of pulmonary nodules [23,24,25] as well as in the primary diagnosis, staging and follow-up after therapy of lung cancer [26,27] or prediction of therapy response is well established [28]. A metaanalysis of surgical NSCLC patients found that high values of SUVmax predicted a higher risk of recurrence or death in patients with surgical NSCLC, among other factors [29].…”

Section: Discussionmentioning

confidence: 99%

Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC

Deininger,

Raacke,

Yousefzadeh-Nowshahr

et al. 2023

Nuklearmedizin

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Aim The aim of this study was to derive prognostic parameters from 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG-PET/CT) in patients with low-risk NSCLC and determine their prognostic value. Methods 81 (21 female, mean age 66 a) therapy-naive patients that underwent [18F]FDG-PET/CT before histologic confirmation of NSCLC with stadium I and II between 2008–2016 were included. A mean follow-up time of 58 months (13–176), overall and progression free survival (OS, PFS) were registered. A volume of interest for the primary tumor was defined on PET and CT images. Parameters SUVmax, PET-solidity, PET-circularity, and CT-volume were analyzed. To evaluate the prognostic value of each parameter for OS, a minimum p-value approach was used to define cutoff values, survival analysis, and log-rank tests were performed, including subgroup analysis for combinations of parameters. Results Mean OS was 58±28 months. Poor OS was associated with a tumor CT-volume >14.3 cm3 (p=0.02, HR=7.0, CI 2.7–17.7), higher SUVmax values >12.2 (p=0.003; HR=3.0, CI 1.3–6.7) and PET-solidity >0.919 (p=0.004; HR=3.0, CI 1.0–8.9). Combined parameter analysis revealed worse prognosis in larger volume/high SUVmax tumors compared to larger volume/lower SUVmax (p=0.028; HR=2.5, CI 1.1–5.5), high PET-solidity/low volume (p=0.01; HR=2.4, CI 0.8–6.6) and low SUVmax/high PET-solidity (p=0.02, HR=4.0, CI 0.8–19.0). Conclusion Even in this group of low-risk NSCLC patients, we identified a subgroup with a significantly worse prognosis by combining morphologic-metabolic biomarkers from [18F]FDG-PET/CT. The combination of SUVmax and CT-volume performed best. Based on these preliminary data, future prospective studies to validate this combined morphologic-metabolic imaging biomarker for potential therapeutic decisions seem promising.

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Section: Discussionmentioning

confidence: 99%

Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC

Deininger,

Raacke,

Yousefzadeh-Nowshahr

et al. 2023

Nuklearmedizin

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“…Both SUV max and SUV mean can represent the uptake level of FDG, but cannot reflect the overall metabolism of tumor. Especially, SUV does not consider the effect of tumor volume on prognosis, and only reflects the metabolic level of mononectin in the lesions (52,53). When extensive metastasis occurs, the tumor load is large, which may be more valuable than the metabolic activity for primary lung cancer prognosis.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of 18F-FDG PET/CT in patients with advanced or metastatic non-small-cell lung cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

Tao¹,

Zhang

Peng

et al. 2022

Front. Immunol.

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PurposeThis study aimed to investigate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in predicting early immunotherapy response of immune checkpoint inhibitors (ICIs) in patients with advanced or metastatic non-small-cell lung cancer (NSCLC).MethodsA comprehensive search of PubMed, Web of science, Embase and the Cochrane library was performed to examine the prognostic value of 18F-FDG PET/CT in predicting early immunotherapy response of ICIs in patients with NSCLC. The main outcomes for evaluation were overall survival (OS) and progression-free survival (PFS). Detailed data from each study were extracted and analyzed using STATA 14.0 software.Results13 eligible articles were included in this systematic review. Compared to baseline 18F-FDG PET/CT imaging, the pooled hazard ratios (HR) of maximum and mean standardized uptake values SUVmax, SUVmean, MTV and TLG for OS were 0.88 (95% CI: 0.69-1.12), 0.79 (95% CI: 0.50-1.27), 2.10 (95% CI: 1.57-2.82) and 1.58 (95% CI: 1.03-2.44), respectively. The pooled HR of SUVmax, SUVmean, MTV and TLG for PFS were 1.06 (95% CI: 0.68–1.65), 0.66 (95% CI: 0.48-0.90), 1.50 (95% CI: 1.26-1.79), 1.27 (95% CI: 0.92-1.77), respectively. Subgroup analysis showed that high MTV group had shorter OS than low MTV group in both first line group (HR: 1.97, 95% CI: 1.39-2.79) and undefined line group (HR: 2.11, 95% CI: 1.61-2.77). High MTV group also showed a shorter PFS in first line group (HR: 1.85, 95% CI: 1.28-2.68), and low TLG group had a longer OS in undefined group (HR: 1.37, 95% CI: 1.00-1.86). No significant differences were in other subgroup analysis.ConclusionBaseline MTV and TLG may have predictive value and should be prospectively studied in clinical trials. Baseline SUVmax and SUVmean may not be appropriate prognostic markers in advanced or metastatic NSCLC patients treated with ICIs.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323906, identifier CRD42022323906.

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“…It is worth mentioning that the uptake of FDG in the tumor and its clearance from the blood and other organs is a dynamic process, and therefore the SUV results are time-dependent and usually increase over time for at least 60 min, and then gradually descend [9,35]. Accordingly, dynamic scan acquisition protocols have been a focus of studies seeking to evaluate therapeutic response in lung cancer [36].…”

Section: Semiquantitative and Quantitative Measurementsmentioning

confidence: 99%

PET/CT in treatment response assessment in lung cancer. When should it be recommended?

Bin Essa,

Kaplar,

Balaji

et al. 2023

Nuclear Medicine Communications

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Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Different treatment options are now possible both for surgical candidates and for those NSCLC patients deemed not suitable for surgery. Despite the treatments available, only a limited number of less advanced stages are potentially curable, with many patients suffering local recurrence or distant metastases. FDG-PET/CT is commonly used in many centers for post-treatment evaluation, follow-up, or surveillance; Nonetheless, there is no clear consensus regarding the indications in these cases. Based upon the results of a literature review and local expertise from a large lung cancer unit, we built clinical evidence-based recommendations for the use of FDG-PET/CT in response assessment. We found that in general this is not recommended earlier than 3 months from treatment; however, as described in detail the correct timing will also depend upon the type of treatment used. We also present a structured approach to assessing treatment changes when reporting FDG-PET/CT, using visual or quantitative approaches.

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The Value of the Standardized Uptake Value (SUV) and Metabolic Tumor Volume (MTV) in Lung Cancer

Cited by 17 publications

References 70 publications

Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC

Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC

Prognostic value of 18F-FDG PET/CT in patients with advanced or metastatic non-small-cell lung cancer treated with immune checkpoint inhibitors: A systematic review and meta-analysis

PET/CT in treatment response assessment in lung cancer. When should it be recommended?

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