Prognostic value of metabolic tumor volume of pretreatment 18F-FAMT PET/CT in non-small cell lung Cancer

• Published in: BMC medical imaging 2018-11, Vol.18 (1), p.46-46, Article 46
• Main Authors: Kumasaka, Soma, Nakajima, Takahito, Arisaka, Yukiko, Tokue, Azusa, Achmad, Arifudin, Fukushima, Yasuhiro, Shimizu, Kimihiro, Kaira, Kyoichi, Higuchi, Tetsuya, Tsushima, Yoshito
• Format: Article
• Language: English
• Subjects: 18F-FAMT PET/CT; Amino acids; Cancer; Care and treatment; Clinical decision making; Decision making; Emission analysis; Fluorine; Fluorine isotopes; Glycolysis; Hazard assessment; Health care; Lung cancer; Medical imaging; Medical prognosis; Metabolic tumor volume; Metabolism; Multivariate analysis; Non-small cell lung cancer; Non-small cell lung carcinoma; Parameters; Patient outcomes; Patients; PET; Positron emission; Positron emission tomography; Prognosis; Small cell lung carcinoma; Statistical models; Surgery; Therapy; Tomography; Tumors
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/s12880-018-0292-2

Background This study aimed to determine the prognostic value of positron emission tomography (PET) metabolic parameters--namely metabolic tumor volume (MTV), total lesion glycolysis (TLG), and total lesion retention (TLR)--on fluorine-18 (.sup.18F) fluorodeoxyglucose (FDG) and L- [3-.sup.18F]-[alpha]-methyltyrosine (.sup.18F-FAMT) PET/CT in patients with non-small-cell lung cancer (NSCLC). Methods The study group comprised 112 NSCLC patients who underwent .sup.18F-FDG and .sup.18F-FAMT PET/CT prior to any therapy. The MTV, TLG, TLR, and maximum standardized uptake value (SUV.sub.max) of the primary tumors were determined. Automatic MTV measurement was performed using PET volume computer assisted reading software. (GE Healthcare). Cox proportional hazards models were built to assess the prognostic value of MTV, TLG (for .sup.18F-FDG), TLR (for .sup.18F-FAMT), SUV.sub.max, T stage, N stage, M stage, clinical stage, age, sex, tumor histological subtype, and treatment method (surgery or other therapy) on overall survival (OS). Results Higher TNM, higher clinical stage, inoperable status, and higher values for all PET parameters (both .sup.18F-FAMT and .sup.18F-FDG PET) were significantly associated (P < 0.05) with shorter OS. Multivariate analysis revealed that a higher MTV of .sup.18F-FAMT (hazard ratio [HR]: 2.88, CI: 1.63-5.09, P < 0.01) and advanced clinical stage (HR: 5.36, CI: 1.88-15.34, P < 0.01) were significant predictors of shorter OS. Conclusions MTV of .sup.18F-FAMT is of prognostic value for OS in NSCLC cases and can help guide decision-making during patient management. Keywords: PET, Metabolic tumor volume, Lung cancer, Prognosis, .sup.18F-FAMT PET/CT