The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2019 Jul 01

DOI: 10.23736/S1824-4785.19.03169-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Prognostic value of metabolic parameters on baseline 18F-FDG PET/CT in small cell lung cancer

Mine ARAZ ¹ ✉, Cigdem SOYDAL ¹, Elgin ÖZKAN ¹, Elif SEN ², Demet NAK ¹, Ozlem N. KUCUK ¹, Ugur GÖNÜLLÜ ², K. Metin KIR ¹

¹ Nuclear Medicine Department, Ankara University Medical School, Ankara, Turkey; ² Thoracic Diseases Department, Ankara University Medical School, Ankara, Turkey

BACKGROUND: Maximum standardized uptake value (SUVmax) is the primary quantitave parameter given in 18F-FDG PET/CT reports. Calculations derived from three dimensional metabolic volumetric images have been proposed to be more successful than SUVmax alone in prognostification with a lower interobserver variability in many cancers. We aimed to determine the prognostic value of metabolic parameters dervied from 18F-FDG PET/CT studies in small cell lung cancer (SCLC) patient population with a long follow up time.
METHODS: In this study, 38 consecutive SCLC patients (34M, 4F, age:65.76 8.18 years) who were referred to 18F-FDG PET/CT for staging between October 2006-January 2011 were included. SUVmax, SUVmean, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. Overall survival (OS) was calculated from the date of the initial PET/CT to death from any cause. Survival tables were obtained and Kaplan Meier curves were recunstructed. Mantel- Cox regression analysis was performed in order to invesitgate if any of these parameters have an effect on survival along with other clinical risk factors.
RESULTS: Median SUVmax, SUVmean, SUVpeak, MTV, TLG and LDH values were calculated as 13,.9g/dL, 6.4g/dL,10.69g/dL, 147 cm3, 1898.52 and 375U/L respectively. Median follow-up was 761.23±873.21 days (25,37 months, range:110-3338 days). Since basal 18F-FDG PET/CT scans, all patients were lost in the follow up except for two patients. MTV was a significant prognostic factor in SCLC patients. Estimated mean survival times were 261.0±45.6 (95%CI:171.6-350.3) days in patients with MTV value above the calculated median 147, and 577.0±124.0 (95%CI 333.7-820.2) days in patients with MTV<147. The difference was statistically significant with a p=0.037.
CONCLUSIONS: Baseline whole body MTV reflecting total tumor load is a prognostic index in SCLC. SUV is insufficient to predict prognosis.

KEY WORDS: Carcinoma; Non-small cell; Positron-emission tomography; Prognosis