Prognostic value of metabolic tumor burden on ^sup 18^F-FDG PET in nonsurgical patients with non-small cell lung cancer

• Published in: European journal of nuclear medicine and molecular imaging 2012-01, Vol.39 (1), p.27
• Main Authors: Liao, Shengri, Penney, Bill C, Wroblewski, Kristen, Zhang, Hao, Simon, Cassie A, Kampalath, Rony, Shih, Ming-chi, Shimada, Naoko, Chen, Sheng, Salgia, Ravi, Appelbaum, Daniel E, Suzuki, Kenji, Chen, Chin-tu, Pu, Yonglin
• Format: Article
• Language: English
• Subjects: Cells; Lung cancer; Metabolic syndrome; Patients; Surgery; Tumors
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-011-1934-6

The objective of this study was to assess the prognostic value of metabolic tumor burden on 2-deoxy-2-[^sup 18^F]fluoro-D-glucose (^sup 18^F-FDG) positron emission tomography (PET)/CT measured with metabolic tumor volume (MTV) and total lesion glycolysis (TLG), independent of Union Internationale Contra la Cancrum (UICC)/American Joint Committee on Cancer (AJCC) tumor, node, and metastasis (TNM) stage, in comparison with that of standardized uptake value (SUV) in nonsurgical patients with non-small cell lung cancer (NSCLC). This study retrospectively reviewed 169 consecutive nonsurgical patients (78 men, 91 women, median age of 68 years) with newly diagnosed NSCLC who had pretreatment ^sup 18^F-FDG PET/CT scans. The ^sup 18^F-FDG PET/CT scans were performed in accordance with National Cancer Institute guidelines. The MTV of whole-body tumor (MTV^sub WB^), of primary tumor (MTV^sub T^), of nodal metastases (MTV^sub N^), and of distant metastases (MTV^sub M^); the TLG of whole-body tumor (TLG^sub WB^), of primary tumor (TLG^sub T^), of nodal metastases (TLG^sub N^), and of distant metastases (TLG^sub M^); the SUV^sub max^ of whole-body tumor (SUV^sub maxWB^), of primary tumor (SUV^sub maxT^), of nodal metastases (SUV^sub maxN^), and of distant metastases (SUV^sub maxM^) as well as the SUV^sub mean^ of whole-body tumor (SUV^sub meanWB^), of primary tumor (SUV^sub meanT^), of nodal metastases (SUV^sub meanN^), and of distant metastases (SUV^sub meanM^) were measured with the PETedge tool on a MIMvista workstation with manual adjustment. The median follow-up among survivors was 35 months from the PET/CT (range 2-82 months). Statistical methods included Kaplan-Meier curves, Cox regression, and C-statistics. There were a total of 139 deaths during follow-up. Median overall survival (OS) was 10.9 months [95% confidence interval (CI) 9.0-13.2 months]. The MTV was statistically associated with OS. The hazard ratios (HR) for 1 unit increase of ln(MTV^sub WB^), [radical](MTV^sub T^), [radical](MTV^sub N^), and [radical](MTV^sub M^) before/after adjusting for stage were: 1.47/1.43 (p