Clinical significance of pretreatment metabolic tumor volume and total lesion glycolysis in hypopharyngeal squamous cell carcinomas.

To evaluate the usefulness of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured by pretreatment fluorine 18-fluorodeoxyglucose ((18) F-FDG) positron emission tomography (PET)/computed tomography (CT) as predictors of clinical outcome in hypopharyngeal squamous cell carcinoma (HPSCC). Seventy-eight patients with HPSCC treated with definitive radiotherapy with or without chemotherapy underwent (18) F-FDG PET/CT. Maximum standardized uptake value (SUV max ), MTV, and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining region. Univariate and multivariate analyses identified variables associated with disease-free survival (DFS) and overall survival (OS). Median SUV max , MTV, and TLG were 9.0 (range, 1.7-24.5), 20.5 (0.3-339.9) ml, and 98.9 (0.8-1877.1) g, respectively. The four-year DFS and OS were 56.1% and 52.6%, respectively. On univariate and multivariate analyses, MTV (P = 0.014) and TLG (P = 0.029) were independent prognostic factors for DFS, and MTV (P = 0.002) and TLG (P = 0.002) were independent prognostic factors for OS. MTV and TLG measured by pretreatment (18) F-FDG PET/CT may be useful in predicting the clinical outcomes of HPSCC patients undergoing radiotherapy.

Roh JL ，Kim JS ，Kang BC ，Cho KJ ，Lee SW ，Kim SB ，Choi SH ，Nam SY ，Kim SY ... -  《-》

Prognostic value of preoperative metabolic tumor volume and total lesion glycolysis measured by 18F-FDG PET/CT in salivary gland carcinomas.

Ryu IS ，Kim JS ，Roh JL ，Lee JH ，Cho KJ ，Choi SH ，Nam SY ，Kim SY ... -  《-》

Prognostic significance of standardized uptake value and metabolic tumour volume on ¹⁸F-FDG PET/CT in oropharyngeal squamous cell carcinoma.

Kim JW ，Oh JS ，Roh JL ，Kim JS ，Choi SH ，Nam SY ，Kim SY ... -  《-》

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 ... -  《-》

Total lesion glycolysis: a possible new prognostic parameter in oral cavity squamous cell carcinoma.

We sought to determine potential prognostic value of total lesion glycolysis (TLG) calculated from combined positron emission tomography/computed tomography (PET/CT) in patients with oral cavity squamous cell carcinoma (OSCC). We prospectively studied 126 patients with OSCC who underwent PET/CT before definitive treatment by radical surgery. The metabolic tumor volume (MTV) was calculated for the primary tumor according to an absolute standardized uptake value (SUV) of 3. TLG was calculated as MTV × the average SUV. The nodal SUVmax was also recorded. The median value of SUVmax and TLG were used to divide the patients into two categories (high and low). Patients were followed up until death or for at least 24 months from their surgery. Disease-free (DFS) and disease-specific survivals (DSS) were the main outcome measures. The median TLG of the primary tumor ((T)TLG) was 71.4, and the median nodal SUVmax ((N)SUV) was 7.5. Patients with high (T)TLG (≥ median) had a 2-year DFS of 52% whereas the DFS was 74% for those with a low (T)TLG (P=0.007); the 2-year-DSS rates were 53% vs. 84%, respectively (P<0.001). Similarly, patients with high (N)SUVmax (≥ median) had a 2-year DFS of 42% vs. 70% for patients with a low (N)SUVmax (P=0.001); the 2-year-DSS rates were 39% vs. 78%, respectively (P<0.001). In multivariate analyses, (T)TLG, (N)SUVmax, and pathological nodal status were independent prognostic factors for the 2-year DSS. A 3-point prognostic scoring system was formulated based on the presence or absence of the independent factors. Patients with positive neck nodes, high (N)SUVmax, and high (T)TLG (score 3) had a 32-fold higher risk of cancer death compared with those lacking such risk factors (2-year-DSS=26% vs. 97%, P<0.001). Primary tumor TLG is an independent prognostic factor for cancer control and survival in patients with OSCC. A prognostic scoring system that includes primary tumor TLG, nodal SUVmax, and pathological neck status may be useful for risk stratification in this group of patients.

Abd El-Hafez YG ，Moustafa HM ，Khalil HF ，Liao CT ，Yen TC ... -  《-》