The Association between the Body Mass Index, Chronic Obstructive Pulmonary Disease and SUV of the Non-Tumorous Lung in the Pretreatment [[sup.18]F]FDG-PET/CT of Patients with Lung Cancer

• Published in: Diagnostics (Basel) 2024-06, Vol.14 (11)
• Main Authors: Wehlte, Lukas, Walter, Julia, Daisenberger, Lea, Kuhnle, Felix, Ingenerf, Maria, Schmid-Tannwald, Christine, Brendel, Matthias, Kauffmann-Guerrero, Diego, Heinzerling, Lucie, Tufman, Amanda, Pfluger, Thomas, Völter, Friederike
• Format: Article
• Language: English
• Subjects: Body mass index; Cancer patients; Care and treatment; Health aspects; Immunotherapy; Lung cancer; PET imaging; Sport-utility vehicles
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics14111139

Background: A debate persists on the prognostic value of the pre-therapeutic standardized uptake value (SUV) of non-tumorous lung tissue for the risk assessment of therapy-related pneumonitis, with most studies lacking significant correlation. However, the influence of patient comorbidities on the pre-therapeutic lung SUV has not yet been systematically evaluated. Thus, we aimed to elucidate the association between comorbidities, biological variables and lung SUVs in pre-therapeutic [[sup.18]F]FDG-PET/CT. Methods: In this retrospective study, the pre-therapeutic SUV in [[sup.18]F]FDG-PET/CT was measured in non-tumorous areas of both lobes of the lung. SUV[sub.MEAN], SUV[sub.MAX] and SUV[sub.95] were compared to a multitude of patient characteristics and comorbidities with Spearman’s correlation analysis, followed by a Bonferroni correction and multilinear regression. Results: In total, 240 patients with lung cancer were analyzed. An elevated BMI was significantly associated with increased SUV[sub.MAX] (β = 0.037, p < 0.001), SUV[sub.MEAN] (β = 0.017, p < 0.001) and SUV[sub.95] (β = 0.028, p < 0.001). Patients with chronic obstructive pulmonary disease (COPD) showed a significantly decreased SUV[sub.MAX] (β = −0.156, p = 0.001), SUV[sub.MEAN] (β = −0.107, p < 0.001) and SUV[sub.95] (β = −0.134, p < 0.001). Multiple other comorbidities did not show a significant correlation with the SUV of the non-tumorous lung. Conclusions: Failure to consider the influence of BMI and COPD on the pre-therapeutic SUV measurements may lead to an erroneous interpretation of the pre-therapeutic SUV and subsequent treatment decisions in patients with lung cancer.