Potential Impact of Atelectasis and Primary Tumor Glycolysis on F-18 FDG PET/CT on Survival in Lung Cancer Patients

Abstract

Background: Atelectasis is an important prognostic factor that can cause pleuritic chest pain, coughing or dyspnea, and even may be a cause of death. In this study, we aimed to investigate the potential impact of atelectasis and PET parameters on survival and the relation between atelectasis and PET parameters. Materials and Methods: The study consisted of patients with lung cancer with or without atelectasis who underwent 18 F-FDG PET/CT examination before receiving any treatment.18 F-FDG PET/CT derived parameters including tumor size, SUVmax, SUVmean, MTV, total lesion glycosis (TLG), SUV mean of atelectasis area, atelectasis volume, and histological and TNM stage were considered as potential prognostic factors for overall survival. Results: Fifty consecutive lung cancer patients (22 patients with atelectasis and 28 patients without atelectasis, median age of 65 years) were evaluated in the present study. There was no relationship between tumor size and presence or absence of atelectasis, nor between presence/absence of atelectasis and TLG of primary tumors. The overall one-year survival rate was 83% and median survival was 20 months (n=22) in the presence of atelectasis; the overall one-year survival rate was 65.7% (n=28) and median survival was 16 months (p=0.138) in the absence of atelectasis. With respect to PFS; the one-year survival rate of AT+ patients was 81.8% and median survival was 19 months; the one-year survival rate of AT-patients was 64.3% and median survival was 16 months (p=0.159). According to univariate analysis, MTV, TLG and tumor size were significant risk factors for PFS and OS (p<0.05). However, SUVmax was not a significant factor for PFS and OS (p>0.05). Conclusions: The present study suggested that total lesion glycolysis and metabolic tumor volume were important predictors of survival in lung cancer patients, in contrast to SUVmax. In addition, having a segmental lung atelectasis seems not to be a significant factor on survival.

Incidental Abnormal FDG Uptake in the Prostate on 18-fluoro-2-Deoxyglucose Positron Emission Tomography-Computed Tomography Scans

“…PET/CT scans are a widely accepted tool for staging and assessing the response to cancer therapy, and 18F-FDG is the most widely using PET tracer in clinical oncology (Hasbek et al, 2014). It also can be useful for cancer screening and evaluating the whole body and performed in Japan reported that FDG-PET/CT scans could detect prostate cancer cases that had a high Gleason score (≥7).…”

Differences in the Prognostic Significance of the SUVmax between Patients with Resected Pulmonary Adenocarcinoma and Squamous Cell Carcinoma

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Hasbek et al, 2014). However, the prognostic significance of the SUVmax based on the histologic type has not yet been fully elucidated.

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Simultaneous pathological findings in biopsy specimens of patients with surgically resected lung carcinoids and their role in survival

“…Atelectasis has been reported as a prognostic factor in other types of lung cancer. More specifically, atelectasis has been shown to be associated with the prolonged survival of patients with non-small cell lung carcinoma (NSCLC) (22)(23)(24)(25) even at advanced stages (26).…”