Quantitative analyses at baseline and interim PET evaluation for response assessment and outcome definition in patients with malignant pleural mesothelioma

Abstract

These results confirm the role of FDG PET in the assessment of disease prognosis and treatment efficacy in MPM patients receiving first-line pemetrexed-based chemotherapy. In particular, metabolic response evaluated using ΔSUVmax can be used to predict outcome in MPM patients not undergoing talc pleurodesis who achieve SD and/or PR at the interim CT evaluation.

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

“…Furthermore, subgroup analysis revealed that the SUVmax was a prognostic factor in patients with epithelioid subtype, but not in those with nonepithelioid subtype. Previous studies suggested a relationship between SUVmax and OS in MPM patients [12][13][14][15][16][17][18][19]. However, this was the first study to suggest that the prognostic role of SUVmax could be limited to the epithelioid subtype only.…”

“…Therefore, the cutoff value of SUVmax should be carefully interpreted with respect to tumor subtype. In previous studies, the cutoff values for SUVmax to [12,14,[16][17][18]. To serve as a prognostic factor in the clinical setting, a standardized method to determine the optimal cutoff value of SUVmax should be established.…”

“…There are multiple prognostic prediction models for MPM, such as the model developed by the European Organization for the Research and Treatment of Cancer (EORTC) and that developed by Cancer and Leukemia Group B (CALGB) [10,11]. Several studies have reported that 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET) parameters, including maximum standardized uptake value (SUVmax), are associated with the prognosis of MPM [12][13][14][15][16][17][18][19]. Few studies have considered clinical factors such as stage, histology, or chemotherapeutic agents as confounding factors in determining the prognosis of patients with MPM.…”

18F-Fluorodeoxyglucose PET/CT and dynamic contrast-enhanced MRI as imaging biomarkers in malignant pleural mesothelioma

“…A number of previous studies [9,[13][14][15][16][17][18][19][20], mostly retrospective and observational, have considered the relationship between survival and PET measurements at baseline. Of these, 8 studies [13][14][15][16][17][18][19][20] with a total of 594 patients found that high SUVmax or TLG at baseline indicated worse survival, and one with 41 patients [9] found no relationship. Three studies have considered percentage change in SUVmax, TLG and MTV after chemotherapy; two [9,12] with a total of 64 patients found that a percentage reduction in TLG was indicative of better OS, while one [20] with 131 patients found a percentage reduction in SUVmax was related to longer OS.…”

“…Of these, 8 studies [13][14][15][16][17][18][19][20] with a total of 594 patients found that high SUVmax or TLG at baseline indicated worse survival, and one with 41 patients [9] found no relationship. Three studies have considered percentage change in SUVmax, TLG and MTV after chemotherapy; two [9,12] with a total of 64 patients found that a percentage reduction in TLG was indicative of better OS, while one [20] with 131 patients found a percentage reduction in SUVmax was related to longer OS. Prior pleurodesis has also been indicated as an issue, causing raised SUVmax in some studies [21,22], but this was not found in our study.…”