Prognostic Value of Tumor-to-Blood Standardized Uptake Ratio in Patients with Resectable Non-Small-Cell Lung Cancer
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Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUVmax). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery.
Seventy-seven patients who underwent curative resection for NSCLC between January 2010 to December 2013 were enrolled in this study. 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed before surgery. The mean standardized uptake value (SUVmean), SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of each lesion was measured, on the workstation. SURmean, SURmax, and TLGSUR were calculated by dividing each of them by descending aorta SUVmean. Cox proportional hazards regression was used to analyze the effect of age, sex, pathological parameters, and PET parameters on recurrence and death.
In Cox regression analysis, N stage predicted for both recurrence (p < 0.0001) and death (p < 0.0001). SURmax predicted recurrence (p = 0.0014), not death. Area under the receiver operating characteristic curve of SURmax was 0.759 with cutoff value 4.004. However, SUVmax, SUVmean, MTV, TLG, SURmean, and TLGSUR predicted neither recurrence nor death.
Among PET parameters, SURmax was the independent predictor of recurrence in NSCLC patients who received curative surgery. N stage was the independent prognostic factor for both recurrence and death. Both parameters could be used to stratify the risk of NSCLC patients.
KeywordsFluorodeoxyglucose F18 Positron-emission tomography Prognosis Non-small-cell lung cancer Recurrence Survival
The manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.
Compliance with Ethical Standards
Conflict of Interest
Seunghyeon Shin, Seong-Jang Kim, In Joo Kim, Kyoungjune Pak and Bum Soo Kim declare that they have no conflict of interest.
The study was approved by an institutional review board or equivalent and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects in the study gave written informed consent or the institutional review board waived the need to obtain informed consent.
- 8.Im HJ, Pak K, Cheon GJ, Kang KW, Kim SJ, Kim IJ, et al. Prognostic value of volumetric parameters of (18)f-fdg pet in non-small-cell lung cancer: a meta-analysis. Eur J Nucl Med Mol Imaging. 2015;42:241–51.Google Scholar
- 13.Asmis TR, Ding K, Seymour L, Shepherd FA, Leighl NB, Winton TL, et al. National Cancer Institute of Canada Clinical Trials G: age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of national cancer institute of Canada clinical trials group trials. J Clin Oncol: Off J Am Soc Clin Oncol. 2008;26:54–9.CrossRefGoogle Scholar
- 16.Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. The iaslc lung cancer staging project: proposals for the revision of the tnm stage groupings in the forthcoming (seventh) edition of the tnm classification of malignant tumours. J Thorac Oncol: Off Publ Int Assoc Study of Lung Cancer. 2007;2:706–14.CrossRefGoogle Scholar
- 17.Berghmans T, Dusart M, Paesmans M, Hossein-Foucher C, Buvat I, Castaigne C, et al. Primary tumor standardized uptake value (suvmax) measured on fluorodeoxyglucose positron emission tomography (fdg-pet) is of prognostic value for survival in non-small cell lung cancer (nsclc): a systematic review and meta-analysis (ma) by the European lung cancer working party for the iaslc lung cancer staging project. J Thorac Oncol. 2008;3:6–12.CrossRefPubMedGoogle Scholar
- 23.Park J, Chang KJ, Seo YS, Byun BH, Choi JH, Moon H, et al. Tumor suvmax normalized to liver uptake on (18)f-fdg pet/ct predicts the pathologic complete response after neoadjuvant chemoradiotherapy in locally advanced rectal cancer. Nucl Med Mol Imaging. 2014;48:295–302.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Shiono S, Abiko M, Okazaki T, Chiba M, Yabuki H, Sato T. Positron emission tomography for predicting recurrence in stage i lung adenocarcinoma: Standardized uptake value corrected by mean liver standardized uptake value. Eur J Cardiothorac Surg: Off J Eur Assoc Cardiothorac Surg. 2011;40:1165–9.Google Scholar