Limited prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) non-small cell lung cancer (NSCLC).

The aim of the current study was to investigate the prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) NSCLC. A retrospective review identified 66 patients with surgically resected early (stage I & II) NSCLC who received dual time point F-18 FDG PET/CT at diagnosis of cancer. Survival analysis was conducted using Kaplan-Meier analysis, and survival curves stratified by age, sex, mediastinal lymph node involvement, TNM staging, SUV(maxE), SUV(maxD), and %ΔSUV(max) were generated for estimation of overall survival and disease-free survival (DFS). Independent predictive factors for survival were determined using Cox proportional hazard model. The overall survival and DFS were better in patients with tumor SUV(maxE)≤5.75 than the patients with tumor SUV(maxE)≥5.75. Seventeen patients (18.2%) with a tumor SUV(maxD)≥6.8 and 4 of 33 patients with tumor SUV(maxD)≤6.8 recurred during follow-up period. The median disease-free survival of the patients with tumor SUV(maxD)≥6.8 was 31.7 months and was significantly worse than the patients with tumor SUV(maxD)≤6.8 (Log rank test, Χ(2)=10.45, p=0.0012). The %ΔSUV(max) did not have prognostic values for overall survival and disease-free survival. The SUV(maxE) and SUV(maxD) were the potent predictors for overall survival. Also, the potent predictor of DFS was the SUV(maxE). In conclusion, %ΔSUV(max) measured by dual time point F-18 FDG PET/CT might not have a prognostic value for overall survival and DFS in surgically resected early stage (stage I & II) NSCLC.

Kim SJ ，Kim YK ，Kim IJ ，Kim YD ，Lee MK ... -  《-》

Limited predictive value of dual-time-point F-18 FDG PET/CT for evaluation of pathologic N1 status in NSCLC patients.

Kim SJ ，Kim YK ，Kim IJ ，Kim YD ，Lee MK ... -  《-》

Prediction of survival and cancer recurrence using F-18 FDG PET/CT in patients with surgically resected early stage (Stage I and II) non-small cell lung cancer.

Kim YS ，Kim SJ ，Kim YK ，Kim IJ ，Kim YD ，Lee MK ... -  《NEOPLASMA》

Prognostic value of metabolic tumor burden from (18)F-FDG PET in surgical patients with non-small-cell lung cancer.

To assess the prognostic value of metabolic tumor burden as measured with metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on 2-deoxy-2-((18)F)fluoro-D-glucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT), independent of current Union Internacional Contra la Cancrum/American Joint Committee on Cancer tumor, node, and metastasis (TNM) stage; in comparison with that of standardized uptake value (SUV) in surgical patients with non-small-cell lung cancer (NSCLC). This study retrospectively reviewed 104 consecutive surgical patients (47 males, 57 females, median age at PET/CT scan of 67.92 years) with diagnosed stage I to IV NSCLC who had baseline (18)F-FDG PET/CT scans. The (18)F-FDG PET/CT scans were performed in accordance with National Cancer Institute guidelines. The MTV of tumors in the whole body (MTV(WB)), TLG of tumors in the whole body (TLG(WB)), the maximum standardized uptake value of tumors in the whole body (SUV(maxWB)) as well as the mean standardized uptake value of tumor in the whole body (SUV(meanWB)) were measured. The median follow-up among 67 survivors was 42.07 months from the PET/CT (range 2.82-80.95 months). Statistical methods included Kaplan-Meier curves, Cox regression, and C-statistics. The interobserver variability of SUV(maxWB), SUV(meanWB), MTV(WB), and TLG(WB) between two observers was analyzed using concordance correlation coefficients (CCCs). The interobserver variability of SUV(maxWB), SUV(meanWB), MTV(WB) and TLG(WB) was very low with CCCs greater than 0.882. There was a statistically significant association of stage with overall survival (OS). The hazard ratio (HR) of stage III and stage IV as compared with stage I was 3.60 (P = .001) and 4.00 (P = .013), respectively. The MTV(WB) was significantly associated with OS with a HR for 1-unit increase of ln(MTV(WB)) of 1.40/1.32 (P = .004/.039), before/after adjusting for stage and other prognostic factors including chemoradiation therapy, and surgical procedure, respectively. TLG(WB) had a statistically significant association with OS before and after adjusting for stage and the other prognostic factors. The HR for 1-unit increase in ln(TLG(WB)) was 1.26 (P = .011) and 1.25 (P = .031), before and after the adjustment, respectively. Subjects with conditions that led to pneumonectomy (HR = 2.82, P = .035) or segmental resection (HR = 3.44, P = .044) had significantly worse survival than those needing lobectomy. There was no statistically significant association between OS and age, gender, tumor histology, ln(SUV(maxWB)), and ln(SUV(meanWB)) (all P > .05). There were 37 deaths during follow-up. Baseline whole-body metabolic tumor burden as measured with MTV(WB) and TLG(WB) on FDG PET is a prognostic measure independent of clinical stage and other prognostic factors including chemoradiation therapy and surgical procedure with low interobserver variability and may be used to further risk stratify surgical patients with NSCLC. This study also suggests that MTV and TLG are better prognostic measures than SUV(max) and SUV(mean). These results will need to be validated in larger cohorts in a prospective study.

Zhang H ，Wroblewski K ，Liao S ，Kampalath R ，Penney BC ，Zhang Y ，Pu Y ... -  《-》

Prognostic value of preoperative metabolic tumor volumes on PET-CT in predicting disease-free survival of patients with stage I non-small cell lung cancer.

Lin Y ，Lin WY ，Kao CH ，Yen KY ，Chen SW ，Yeh JJ ... -  《-》