Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parametersBBpredicts tumor treatment response and survival of stage III non-small cell lung cancer

Abstract

Bacground: To assess the predictive values of primary tumor FDG uptake for patients with inoperable stage III non-small cell lung cancer (NSCLC) after concurrent chemoradiotherapy (CCRT). Methods: A total of 107 patients with diagnosis of stage III NSCLC and CCRT were enrolled in this study. The tumor maximum uptake value (SUVmax) was standardized by calculating several ratios between tumor and each background tissues. The receiver operating characteristics curve (ROC) was used to compare the predictive power of prognostic models. The tumor objective response rate (ORR) and overall survival (OS) were compared and analyzed by the Kaplan–Meier method and univariate and multivariate Cox regression models. Results: The areas under ROC curve (AUCs) ranged from 0.72 to 0,81 among these tumor SUVmax and standardized SUVmax ratios, and the tumor SUVmax and tumor SUVmax-to-liver SUVmean ratio (TLMR) were more predictive of ORR (AUC=0.81; 95% CI, 0.73-0.88 for tumor SUVmax and AUC=0.84; 95%CI, 0.76-0.91 for TLMR) than any of other SUVmax ratios. The patients with lower tumor SUVmax, SUVmean and SUVmax ratios had a significantly better OS than those with their corresponding higher ones. Moreover, both univariate and multivariable analyses revealed that TLMR was significantly associated with better ORR and OS after adjustment with other prognostic variables. Conclusions: TLMR, a standardized tumor SUVmax, was an independent prognostic predictor for tumor ORR and OS of patients with stage III NSCLC after CCRT.

The prognostic value of lymph node to primary tumor standardized uptake value ratio in cancer patients: A meta-analysis

“…Although pretreatment lymph node SUVmax as a sole parameter has been shown to be a signi cant prognosticator in various cancer types(8, 9, 27-31), there are some well-known drawbacks of using nonnormalized SUV, e.g., partial volume effect, uptake time dependence of the SUV, and interstudy variability of image acquisition and reconstruction parameters, which could possibly undermine the reliability of the SUVmax values (12,(32)(33)(34). The strength of NTR is that by normalizing the lymph node SUVmax to the primary tumor SUVmax, NTR may be less susceptible to the inter-scanner variability, and may have better generalizability (20,(35)(36)(37)(38)(39)(40)(41). In a study on esophageal squamous cell carcinoma patients, Lin et al assessed the potential impact of employing different PET/CT scanners on the NTR and lymph node SUVmax, and demonstrated that the variation of the optimal cutoff values and the interquartile range of the NTR obtained by the two different PET/CT scanners was minimal, while the non-normalized lymph node SUVmax suffered signi cantly greater inter-scanner variability (20).…”

Potential role of pre-treatment bone marrow SUVmean to liver SUVmean ratio (BM/L) and comparison of primary tumour FDG uptake with brain FDG uptake in predicting survival in limited-stage lung cancers

“…Therefore, early prediction of the treatment process is crucial. Many studies evaluating BM/L in patients with non-SCLC have reported that PFS and OS were worse in patients with BM/L > 1 [21,[29][30][31][32]. However, there are no studies evaluating these parameters in patients with LD-SCLC.…”

“…Therefore, early prediction of the treatment process is crucial. Many studies evaluating BM/L in patients with non-SCLC have reported that PFS and OS were worse in patients with BM/L > 1 [21,29–32].…”