Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis

Im, Hyung Jun; Pak, Kyoungjune; Cheon, Gi Jeong; Kang, Keon Wook; Kim, Seong Jang; Kim, In Joo; Chung, June Key; Kim, E. Edmund; Lee, Dong Hoon

doi:10.1007/s00259-014-2903-7

Cited by 210 publications

(161 citation statements)

References 54 publications

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“…To overcome these limitations of SUV, MTV and TLG have been studied as prognostic factors for NSCLC (7,8,10,14,15 (10). Other studies have confirmed that TLG and MTV are better indices of patient survival than SUV max or mean SUV (7,8,10,14,15). Previous studies focused primarily on advanced-stage disease, and few studies have reported the role of volume-based parameters in early-stage NSCLC.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Park

Cho

et al. 2014

J Nucl Med

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Despite the favorable prognosis of stage IA non-small cell lung cancer (NSCLC), the disease recurs after complete surgical resection in 20%-30% of patients. This study determined the prognostic value of various metabolic parameters of 18 F-FDG PET/CT in surgically resected stage IA NSCLC. Methods: We retrospectively reviewed 248 patients with stage IA NSCLC who underwent lobectomy and complete lymph node dissection after PET/CT. A region of interest was drawn on the primary lesion, and metabolic indices such as metabolic tumor volume, maximum standardized uptake value (SUV max ), and total lesion glycolysis (TLG) were measured using an SUV cutoff of 2.5. Results: The patients included 134 men and 114 women, and the mean age was 63.03 ± 10.01 y; 129 were stage T1a (#2 cm) and 119 were T1b (.2 cm). The median follow-up period was 36.6 mo. Recurrence took place in 15 patients. The mean (±SD) SUV max , metabolic tumor volume, and TLG were 4.55 ± 3.75, 5.92 ± 5.57, and 14.42 ± 17.35, respectively. The cutoffs of SUV max and TLG were 3.7 and 13.76, respectively. The 5-y overall survival (OS) was 95.1% in low-SUV max patients and 82.2% in high-SUV max patients (P 5 0.02). The 5-y OS was 93.7% in low-TLG patients and 78.3% in high-TLG patients (P 5 0.01). On multivariate analysis, TLG was a risk factor for OS (hazard ratio, 3.159; P 5 0.040), but SUV max showed marginal significance (P 5 0.064). The concordance index of the TLG model was 0.676 (95% CI, 0.541-0.812). Conclusion: TLG was a significant prognostic factor for OS in patients with stage IA NSCLC. Lungcanceri s the second most common cancer in both men and women and the most common cause of cancer death in the world (1). Non-small cell lung cancer (NSCLC) accounts for 80%-85% of all lung cancer cases. Oncologic treatment options for NSCLC typically include surgery, radiation, and chemotherapy, either alone or in combination. TNM stage has been considered the primary prognostic factor in NSCLC. However, tumor-and patientspecific factors vary even within the same disease stage, creating a heterogeneous population of patients, each with an individual prognosis that requires consideration of patient-and tumor-specific factors for best estimation (2,3). Recently, the incidence of earlystage NSCLC has increased as a result of the use of low-dose CT for screening. However, despite having early-stage disease, up to 20%-30% of patients with stage IA NSCLC relapse after surgical treatment. Therefore, other prognostic factors besides TNM stages are needed to identify patients at high risk for recurrence, predict prognosis, and recommend individualized adjuvant therapy (4).18 F-FDG PET relies on the fact that most neoplasms are highly metabolically active and therefore can be detected on a background of relatively less active normal tissues. When performed in addition to qualitative evaluation by visual inspection, 18 F-FDG PET can provide several semiquantitative measurements of radioactivity concentration in each tissue compartment, such as standardized uptake value (SUV...

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Section: Discussionmentioning

confidence: 99%

“…MTV indicates the volume of metabolically active tumor, and TLG is the product of mean SUV and MTV (6). Studies have shown that TLG is a better index of patient prognosis than SUV max in advanced NSCLC (7)(8)(9)(10)(11)(12). However, the prognostic role of volume-dependent parameters in stage IA NSCLC has not been reported.…”

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confidence: 99%

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Park

Cho

et al. 2014

J Nucl Med

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“…SUV maks değerinin hesaplanmasında lezyon çevresine çizilen ilgi alanı içinde yer alan ve maksimum aktiviteye sahip vokselden yapılan ölçüm dikkate alınır. Yakın zamanlı çalışmalar MTV ve TLG'nin hem primer tümörün hem de tüm vücuttaki toplam tümör yükünün yansıması olarak, ayrıca metabolik ve hacimsel bilgiyi bir araya getirmeleri nedeniyle SUV'ye göre prognozu öngörmede daha başarılı olduğunu işaret etmektedir (48,49,50,51,52). KHDAK'nin tüm evrelerinde yüksek MTV ve TLG yüksek advers olay riski ve düşük sağkalım ile ilişkilidir (48,51,52).…”

Section: Fdg Pet/bt Bulgularının Sayısal Analiziunclassified

“…Yakın zamanlı çalışmalar MTV ve TLG'nin hem primer tümörün hem de tüm vücuttaki toplam tümör yükünün yansıması olarak, ayrıca metabolik ve hacimsel bilgiyi bir araya getirmeleri nedeniyle SUV'ye göre prognozu öngörmede daha başarılı olduğunu işaret etmektedir (48,49,50,51,52). KHDAK'nin tüm evrelerinde yüksek MTV ve TLG yüksek advers olay riski ve düşük sağkalım ile ilişkilidir (48,51,52). KHDAK'sinde SUV maks MTV ve TLG'nin hasta prognozu ile ilişkisini değerlendirmeye yönelik çalışmaların derlendiği 36 makale ve 5807 hasta verisi içeren bir meta-analizde bu değerlerin cerrahi tedavi sonrası genel ve hastalıksız sağkalım bakımından öngörü değeri taşıdığı gösterilmiştir (53).…”

Section: Fdg Pet/bt Bulgularının Sayısal Analiziunclassified

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

Akdemir¹,

Aydos²

2018

Nts

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GirişAkciğer kanseri, en sık görülen kanser türlerinden biri olup, tedavi olanaklarındaki iyileşmelere rağmen kansere bağlı ölüm nedenleri arasında birinci sırada yer alır (1). Tüm akciğer kanserlerinin yaklaşık %85'ini küçük hücreli dışı akciğer kanseri (KHDAK), kalan kısmını da küçük hücreli akciğer kanseri (KHAK) oluşturur (2).KHAK hastalarının çoğunda tanı anında uzak metastaz bulunması ve bu hastaların cerrahi tedavi olasılıklarının düşük olması; buna karşılık KHDAK hastalarında cerrahi tedavi olasılığının daha yüksek olması nedeniyle bu sınıflama özellikle tedavi yaklaşımı bakımından önem taşır. Akciğer kanseri tanısı alan hastalarda uygun tedavi seçeneğini belirlemek ve hasta prognozunu Flor-18 ile işaretli florodeoksiglikoz (FDG) ile yapılan pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/ BT) akciğerde kuşkulu parankimal nodülü olan veya akciğer kanseri tanısı alan hastaların klinik yönetiminde kullanılan güçlü bir tanı aracıdır. Bu yazıda FDG PET/BT görüntülemenin kuşkulu akciğer nodüllerinin değerlendirilmesinde ve yeni tanı akciğer kanserinde evrelemesindeki yerinden, sayısal PET değişkenlerinin hasta prognozu ile ilişkisinden, hibrid PET/manyetik rezonans sistemi gibi teknik gelişmelerden ve akciğer kanserinin patofizyolojisi ile ilişkili FDG dışındaki diğer PET radyofarmasötiklerinin kullanımından bahsedilmektedir. Anahtar Kelimeler: Akciğer kanseri, küçük hücreli-dışı akciğer kanseri, küçük hücreli akciğer kanseri, FDG, PET/BT görüntüleme Positron emission tomography/computed tomography (PET/ CT) using fluorine-18 labelled fluorodeoxyglucose (FDG) is a powerful tool for managing patients with suspected lung nodules and lung cancer. In this review, we discuss the utility of FDG PET/CT imaging in evaluation of suspected pulmonary nodules and initial staging of patients with newly diagnosed lung cancer, prognostic value of quantitative PET parameters, technical developments in PET imaging such as hybrid PET/ magnetic resonance systems, and the use of other PET radiopharmaceuticals related to lung cancer pathophysiology.

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“…PET/CT imaging provides anatomic and metabolic information, which is important for detection, localization, and characterization of the disease (2,3). Furthermore, quantitative indices in PET, such as standardized uptake value (SUV) (4,5), metabolic volume (6,7), and total lesion glycolysis (5-7), can be used to provide prognostic information and predict and monitor therapy response (4)(5)(6)(7).…”

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confidence: 99%

Improving the Spatial Alignment in PET/CT Using Amplitude-Based Respiration-Gated PET and Respiration-Triggered CT

et al. 2015

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Respiratory motion during PET can cause inaccuracies in the quantification of radiotracer uptake, which negatively affects PETguided radiotherapy planning. Quantitative accuracy can be improved by respiratory gating. However, additional miscalculation of standardized uptake value (SUV) in PET images can be caused by inappropriate attenuation correction due to a spatial mismatch between gated PET and CT. In this study, the effect of respirationtriggered CT on the spatial match between CT and amplitude-based respiration-gated PET images is investigated. Methods: 18 F-FDG PET/CT was performed in 38 patients. Images were acquired on 2 PET/CT scanners, one without and one with continuous bed motion during PET acquisition. The amplitude limits of the amplitude-based respiration-gated PET were used for the respiration-triggered sequential low-dose CT. Both standard (spiral) and triggered CT scans were used to reconstruct the PET data. Spatial mismatch was quantified using the position difference between the lung-liver boundary in PET and CT images, the distance between PET and CT lung lesions' centroids, and the amount of overlap of lesions indicated by the Jaccard similarity coefficient. Furthermore, the effect of attenuation correction was quantified by measuring SUVs in lung lesions. Results: For triggered CT, the average distance between the lung-liver boundary in PET and CT was significantly reduced (4.5 ± 6.7 mm) when compared with standard CT (9.2 ± 8.1 mm) (P , 0.001). The mean distance between the lesions' centroids in PET and CT images was 6.3 ± 4.0 and 5.6 ± 4.2 mm (P 5 0.424), for the standard and triggered CT, respectively. Similarly, the Jaccard similarity coefficient was 0.30 ± 0.21 and 0.32 ± 0.20 (P 5 0.609) for standard and triggered CT, respectively. For 6 lesions, there was no overlap of PET and CT when the standard CT was used; compared with the triggered CT, these lesions showed (partial) overlap. The maximum and mean SUV increase of the PET/CT compared with the PET/triggered CT was 5.7% ± 11.2% (P , 0.001) and 6.1% ± 10.2% (P 5 0.001), respectively. Conclusion: Amplitude-based respiration-gated PET in combination with respiration-triggered CT resulted in a significantly improved match in the area of the liver dome and a significantly higher SUV for lung lesions. However, lesions in the lungs did not show a consistent improvement in spatial match.

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Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis

Cited by 210 publications

References 54 publications

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

Improving the Spatial Alignment in PET/CT Using Amplitude-Based Respiration-Gated PET and Respiration-Triggered CT

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Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis

Cited by 210 publications

References 54 publications

Prognostic Value of Total Lesion Glycolysis by 18F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Prognostic Value of Total Lesion Glycolysis by 18F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

Improving the Spatial Alignment in PET/CT Using Amplitude-Based Respiration-Gated PET and Respiration-Triggered CT

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Product

Resources

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Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer

Prognostic Value of Total Lesion Glycolysis by ¹⁸F-FDG PET/CT in Surgically Resected Stage IA Non–Small Cell Lung Cancer