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Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis

European Journal of Nuclear Medicine and Molecular Imaging volume 42, pages 241–251 (2015)Cite this article

Abstract

Purpose

We conducted a comprehensive systematic review of the literature on volumetric parameters from 18F-FDG PET and a meta-analysis of the prognostic value of metabolic tumour volume (MTV) and total lesion glycolysis (TLG) in patients with lung cancer.

Methods

A systematic search of MEDLINE and EMBASE was performed using the keywords “positron emission tomography (PET)”, “lung cancer”, and “volume”. Inclusion criteria were: 18F-FDG PET used as an initial imaging tool; studies limited to non-small-cell lung cancer (NSCLC); volume measurement of lung cancer; patients who had not undergone surgery, chemotherapy, or radiotherapy before the PET scan; and studies that reported survival data. Event-free survival and overall survival were evaluated as outcomes. The impact of MTV and TLG on survival was measured in terms of the hazard ratio (HR) effect size. Data from each study were analysed using Review Manager 5.2.

Results

Thirteen eligible studies including 1,581 patients were analysed. Patients with high MTV showed a worse prognosis with an HR of 2.71 (95 % CI 1.82 – 4.02, p < 0.00001) for adverse events and an HR of 2.31 (95 % CI 1.54 – 3.47, p < 0.00001) for death. Patients with high TLG also showed a worse prognosis with an HR of 2.35 (95 % CI 1.91 – 2.89, p < 0.00001) for adverse events and an HR of 2.43 (95 % CI 1.89 – 3.11, p < 0.00001) for death. The prognostic value of MTV and TLG remained significant in a subgroup analysis according to TNM stage as well as the methods for defining cut-off values and tumour delineation.

Conclusion

Volumetric parameters from 18F-FDG PET are significant prognostic factors for outcome in patients with NSCLC. Patients with a high MTV or TLG are at higher risk of adverse events and death. MTV and TLG were significant prognostic factors in patients with TNM stage I/II and stage III/IV NSCLC.

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Acknowledgments

This study was supported by the National Research Fund (grant no. HI13C1299) of the Korea Health Industry Development Institute (KHIDI) and an Intramural Research Grant from Seoul National University.

Conflicts of interest

None.

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Affiliations

  1. Department of Nuclear Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Hyung-Jun Im, Kyoungjune Pak, Gi Jeong Cheon, Keon Wook Kang, June-Key Chung & Dong Soo Lee

  2. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul, South Korea

    Hyung-Jun Im, E. Edmund Kim & Dong Soo Lee

  3. Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea

    Kyoungjune Pak, Seong-Jang Kim & In-Joo Kim

  4. Cancer Research Institute, Seoul National University Hospital, Seoul, South Korea

    Gi Jeong Cheon, Keon Wook Kang, June-Key Chung & Dong Soo Lee

  5. Department of Radiological Science, University of California at Irvine, California, CA, USA

    E. Edmund Kim

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  1. Hyung-Jun Im
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  2. Kyoungjune Pak
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  3. Gi Jeong Cheon
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  8. E. Edmund Kim
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  9. Dong Soo Lee
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Corresponding author

Correspondence to Gi Jeong Cheon.

Additional information

Hyung-Jun Im and Kyoungjune Pak contributed equally to this work.

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Im, HJ., Pak, K., Cheon, G.J. et al. Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis. Eur J Nucl Med Mol Imaging 42, 241–251 (2015). https://doi.org/10.1007/s00259-014-2903-7

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Keywords

  • PET
  • Volume
  • Lung cancer
  • Prognosis