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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 March;66(1):61-6

DOI: 10.23736/S1824-4785.19.03169-8


lingua: Inglese

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 3, K. Metin KIR 1

1 Department of Nuclear Medicine, Ankara University Medical School, Ankara, Turkey; 2 Department of Thoracic Diseases, Ankara University Medical School, Ankara, Turkey; 3 Department of Thoracic Diseases, Atilim 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 derived 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 reconstructed. Mantel-Cox regression analysis was performed in order to investigate 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 13.9 g/dL, 6.4 g/dL,10.69 g/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 lung; Positron-emission tomography; Prognosis

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