Prognostic value of ¹⁸F-FDG PET/CT metabolic parameters in small cell lung cancer

Abstract

Objective To compare the prognostic values of metabolic parameters from pretreatment PET/CT between limited disease (LD) and extensive disease (ED) small cell lung cancer (SCLC) patients. Methods Data on 118 newly diagnosed SCLC patients (50 LD and 68 ED) who underwent pretreatment positron emission tomography–computed tomography (PET/CT) were reviewed. For PET, metabolic parameters were measured for: (1) primary tumor, maximum standardized uptake value (SUVmax), metabolic tumor volume, and total lesion glycolysis; and (2) all tumor lesions, SUVmax of the hottest tumor, whole body metabolic tumor volume (WBMTV), and whole body total lesion glycolysis (WBTLG). Prognostic values of metabolic parameters and other clinical variables were analyzed to predict overall survival (OS). Results In LD, SUVmax of the primary tumor was an independent prognostic factor for OS. Patients with high SUVmax showed significantly worse OS than those with low SUVmax. In ED, WBMTV and WBTLG were independent prognostic factors for OS. Patients with high WBMTV or WBTLG showed significantly worse OS than those with low WBMTV or WBTLG. Conclusions SUVmax of primary tumor was the only independent prognostic factor for OS in LD SCLC patients. WBMTV and WBTLG were independent prognostic factors in ED SCLC patients.

Prognostic Value of 18F–FDG–PET Parameters in Patients with Small Cell Lung Cancer: A Meta-Analysis and Review of Current Literature

“…Baseline SUV max was addressed in 28 studies, but only seven studies showed a significant prognostic value of SUV max for OS and/or PFS [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

“…Twelve studies included baseline SUV max in a multivariate analysis. In five studies, SUV max were independently prognostic for OS [ 18 , 19 , 20 , 21 , 25 ]. No study showed an independent prognostic value for PFS [ 12 , 25 , 32 , 33 ].…”

“…MTV3.0 throughout the whole body (wbMTV3.0) had a prognostic value for OS in four of four studies [ 12 , 13 , 18 , 28 ], though partial cohort overlap of two of the studies should be noticed [ 12 , 13 ]. wbMTV3.0 had a prognostic value for PFS in two of three studies [ 13 , 28 ].…”

“…wbMTV3.0 had a prognostic value for PFS in two of three studies [ 13 , 28 ]. MTV3.0 measured in the primary tumor (tMTV3.0), measured in all intrathoracic tumors, or in the hottest tumor did not show a significant prognostic value [ 13 , 18 ].…”

“…Figure 3 b gives an overview of the independent prognostic value of PET parameters and the most investigated covariates. MTV had an additional or superior prognostic value to stage [ 12 , 23 , 32 , 33 , 35 ], age [ 18 , 26 , 28 , 35 ], LDH [ 12 , 18 , 23 , 26 ], sex [ 18 , 26 , 28 ], and PS [ 12 , 13 , 16 , 28 ] in most studies. Only three studies identified a clinical covariate with a superior prognostic value to MTV: stage [ 32 ], stage and treatment response [ 29 ], and PS, chemotherapy and number of extrathoracic metastases [ 13 ].…”