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18Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography total glycolytic volume in thymic epithelial neoplasms evaluation: a reproducible image biomarker

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Abstract

Introduction

18Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography is not yet accepted as a standard pretreatment evaluation of thymic epithelial neoplasm (TEN). Statistical correlation between standardized uptake value of tumor/mediastinum ratio and patients’ WHO risk class has been reported. PET metabolic tumor volume (MTV) and total glycolytic volume (TGV) have been reported as additional prognostic imaging biomarkers in several human tumors. Purpose of study was to establish whether MTV and TGV add prognostic information in TEN.

Materials and methods

A retrospective dynamic cohort study of prospectively collected data (2006–2012) on 23 consecutive patients with pathologically proven TEN (no thymic carcinoma) was conducted. All patients underwent chest CT, and PET for staging. SUV T/M ratio, semi-quantitative and volumetric analyses of TEN were calculated. Patients were categorized according to WHO classification (low-risk and high-risk thymomas). Statistical analysis was performed with bootstrap method. Multi-collinearity was established using Pearson correlation coefficient. Cut-off point for TGV was compared using Mantel Cox log rank test.

Results

SUV T/M ratio, MTV, and TGV correlate with low- and high-risk TEN. However, the statistical correlation between TGV and WHO classification (ρ = 0.897) was higher than SUV T/M ratio (ρ = 0.873). Since sample distributions were not uniformly smooth, only one cut-off value was identified: a TGV of 383 served as a cut-off value between low-risk and high-risk TEN.

Conclusion

TGV is a PET reproducible imaging marker in patients with TEN, provides prognostic information, and could be useful in pretreatment stratification of patients. Nevertheless, it needs validation in larger cohort studies.

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Conflict of interest

All the authors have no conflict of interest.

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Authors and Affiliations

  1. Division of Thoracic Surgery Unit, S. Croce e Carle Hospital, Via Michele Coppino 26, 12100, Cuneo, Italy

    Luca Bertolaccini & Andrea Viti

  2. Medical Physics Service, S. Croce e Carle Hospital, Cuneo, Italy

    Eleonora Lanzi & Stephane Chauvie

  3. Pathology Service, S. Croce e Carle Hospital, Cuneo, Italy

    Mirella Fortunato

  4. Nuclear Medicine Service, S. Croce e Carle Hospital, Cuneo, Italy

    Andrea Bianchi

  5. Section of Thoracic Surgery, Sacred Heart Hospital, Negrar (Verona), Italy

    Alberto Terzi

Authors
  1. Luca Bertolaccini
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  2. Andrea Viti
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  3. Eleonora Lanzi
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  4. Mirella Fortunato
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  5. Stephane Chauvie
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  6. Andrea Bianchi
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  7. Alberto Terzi
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Correspondence to Luca Bertolaccini.

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Bertolaccini, L., Viti, A., Lanzi, E. et al. 18Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography total glycolytic volume in thymic epithelial neoplasms evaluation: a reproducible image biomarker. Gen Thorac Cardiovasc Surg 62, 228–233 (2014). https://doi.org/10.1007/s11748-014-0374-1

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  • DOI: https://doi.org/10.1007/s11748-014-0374-1

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