Prognostic value of metabolic parameters measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography in surgically resected non-small cell lung cancer patients

Boon Mathew; Nilendu C. Purandare; Ameya Puranik; Sneha Shah; Archi Agrawal; C.S. Pramesh; George Karimundackal; Sabita Jiwnani; Venkatesh Rangarajan

doi:10.4103/wjnm.WJNM_26_19

World Journal of Nuclear Medicine, Table of Contents

CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(01): 8-14
DOI: 10.4103/wjnm.WJNM_26_19

Original Article

Prognostic value of metabolic parameters measured by ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography in surgically resected non-small cell lung cancer patients

Boon Mathew

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Nilendu C. Purandare

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Ameya Puranik

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Sneha Shah

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Archi Agrawal

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

C.S. Pramesh

¹Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

George Karimundackal

¹Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Sabita Jiwnani

¹Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

,

Venkatesh Rangarajan

Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

› Author Affiliations

Abstract

¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography-derived metabolic parameters can play a role in prognostication. We investigated the prognostic value of various metabolic parameters such as maximum standardized uptake value (SUV_max), mean SUV (SUV_mean), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG) in surgically resected non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed 153 patients with NSCLC who underwent surgical resection. The SUV_max, SUV_mean, WBMTV, and WBTLG of the tumor were measured. Continuous PET parameters were stratified by receiver operating characteristic curve analysis. Prognostic factors were estimated using the Kaplan–Meier method and Cox proportional hazards model. The median follow-up was 36.9 months. Fifty-six patients died and 78 patients had recurrence. On univariate analysis, tumor-node-metastasis (TNM) stage; male sex; no adjuvant treatment; and higher SUV_max, SUV_mean, WBMTV, and WBTLG were statistically significant and were associated with poor overall survival (OS). TNM stage; no adjuvant treatment; and higher SUV_max, SUV_mean, WBMTV, and WBTLG were statistically significant and were associated with poor disease-free survival (DFS). On multivariate analysis, higher WBTLG (hazard ratio [HR] = 3.08, P = 0.007) for DFS and higher WBTLG (HR = 2.70, P = 0.041) and TNM staging (HR = 1.63, P = 0.035) for OS were statistically significant. Whole-body tumor burden assessment with TLG has independent prognostic value in patients with operated lung cancer. Incorporation of TLG into clinical practice can identify patients benefitted from additional therapy.

Keywords

¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography - lung cancer - metabolic parameters - prognostic value - total lesion glycolysis

Full Text

References

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