Prognostic value of SUVmax on 18F-fluorodeoxyglucose PET/CT scan in patients with malignant pleural mesothelioma

Abstract

IntroductionThe maximum standardized uptake value (SUVmax) in 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) may be of prognostic significance for patients with malignant pleural mesothelioma (MPM). This retrospective study aimed to investigate the prognostic value of the SUVmax in patients with MPM. Materials and methodsMedical records were retrospectively reviewed for the patients who were diagnosed with histopathologically proven MPM between 2009 and 2018 at Samsung Medical Center. For each patient, SUVmax was calculated for the primary lesion on PET/CT. To determine optimal cutoff values for predicting mortality, receiver operating characteristic curves were used. ResultsAmong the 54 study patients, 34 (63.0%) had epithelioid subtype, 13 (24.1%) had sarcomatoid or biphasic subtype, and 7 (13.0%) had mesothelioma, not otherwise specified (NOS). The median overall survival (OS) was 8.7 months, and the median SUVmax was 9.9. The median values of SUVmax were 5.5 in patients with epithelioid subtype, 11.7 in those with sarcomatoid/biphasic subtype, and 13.3 in those with NOS subtype (P = 0.003). The optimal cutoff values of SUVmax to predict mortality were 10.1 in all patients, and 8.5 in patients with epithelioid subtype. In multivariate analysis, SUVmax was significantly associated with overall survival in all patients (P = 0.003) and in patients with epithelioid subtype (P = 0.012), but not in those with non-epithelioid subtype. ConclusionsSUVmax in PET/CT is an independent prognostic factor in patients with MPM, especially those with epithelioid subtype. The histologic subtype of MPM should be considered when evaluating the prognostic significance of SUVmax.

Prognostic value of metabolic parameters on 18F-fluorodeoxyglucose positron tomography/computed tomography in classical rectal adenocarcinoma

“…Among these, 18 F-FDG PET/CT, which reflects glucose utilization of target tissues, not only allows the optimal choice of therapeutic management but also assesses prognosis 12 – 16 . Previous studies with several kinds of malignancies have reported the clinical usefulness of using metabolic parameters of 18 F-FDG PET/CT, such as maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG), for prediction of prognosis 17 – 20 . However, there are only a few studies focusing on the prognostic value of metabolic parameters in patients with rectal cancer 21 – 25 .…”

The use of a next-generation sequencing-derived machine-learning risk-prediction model (OncoCast-MPM) for malignant pleural mesothelioma: a retrospective study

“…3,[5][6][7] Unfortunately, imaging can under estimate the disease burden, 7 and aggressive types of disease exist within the more indolent epithelioid subtype, which limits the prognostic accuracy of these characteristics. 7,8 AbdelRahman applied the staging method used by the eighth American Joint Committee on Cancer (AJCC) to 5382 patients with malignant pleural mesothelioma and determined that prognostic per formance was poor, and that better staging systems are needed for patients with this disease. 9 Several studies have tried to further refine histological classification to better understand the heterogeneity of epithelioid disease, [10][11][12][13][14][15] including Courtiol and colleagues' study 16 in which they used a deep learningbased approachknown as MesoNet-to examine wholeslide digitised images to predict overall survival.…”

False-Negative 18F-Fluorodeoxyglucose PET/CT in Malignant Pleural Mesothelioma

“…According to 2018 American Society of Clinical Oncology (ASCO) guidelines, diagnosis of MPM is made using thoracentesis with cytology of fluid or thoracoscopic biopsy, while FDG PET/CT should be obtained as part of initial staging [6]. In addition to its value in staging MPM, SUVmax on FDG PET/CT has been shown to have prognostic value, predicting overall survival [7], especially in MPM of the epithelioid subtype [8].…”