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Volume-based assessment by 18F-FDG PET/CT predicts survival in patients with stage III non-small-cell lung cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the prognostic impact of volume-based assessment by 18F-FDG PET/CT in patients with stage III non-small-cell lung cancer (NSCLC).

Methods

We reviewed 194 consecutive patients with stage IIIA NSCLC treated with surgical resection (surgical group) and 115 patients treated with nonsurgical therapy (nonsurgical group: 50 stage IIIA, 65 stage IIIB). Metabolic tumour volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) of primary tumours were measured using pretreatment 18F-FDG PET/CT. Overall survival was assessed using the Kaplan-Meier method. The prognostic significance of PET parameters and other clinical variables was assessed using Cox proportional hazards regression analyses. To evaluate and compare the predictive performance of PET parameters, time-dependent receiver operating characteristic (ROC) curve analysis was used.

Results

In the Cox proportional hazards models, MTV (HR = 1.27 for a doubling of MTV, P = 0.008) and TLG (HR = 1.22 for a doubling of TLG, P = 0.035) were significantly associated with an increased risk of death after adjusting for age, gender, histological cell type, T stage, N stage, and treatment variables in the surgical group. SUVmax was not a significant prognostic factor in either the surgical or nonsurgical group. In the time-dependent ROC curve analysis, volume-based PET parameters predicted survival better than SUVmax.

Conclusion

The volume-based PET parameters (MTV and TLG) are significant prognostic factors for survival independent of tumour stage and better prognostic imaging biomarkers than SUVmax in patients with stage IIIA NSCLC after surgical resection.

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Acknowledgments

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (#1120150).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Seung Hyup Hyun & Joon Young Choi

  2. Division of Hematology-Oncology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Republic of Korea

    Hee Kyung Ahn

  3. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Hojoong Kim

  4. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Myung-Ju Ahn & Keunchil Park

  5. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yong Chan Ahn

  6. Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jhingook Kim & Young Mog Shim

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  1. Seung Hyup Hyun
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  9. Joon Young Choi
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Correspondence to Joon Young Choi.

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Hyun, S.H., Ahn, H.K., Kim, H. et al. Volume-based assessment by 18F-FDG PET/CT predicts survival in patients with stage III non-small-cell lung cancer. Eur J Nucl Med Mol Imaging 41, 50–58 (2014). https://doi.org/10.1007/s00259-013-2530-8

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  • DOI: https://doi.org/10.1007/s00259-013-2530-8

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