Risk stratification of solitary pulmonary nodules by means of PET using 18F-fluorodeoxyglucose and SUV quantification

Grgic, Aleksandar; Yüksel, Y.; Gröschel, A.; Schäfers, Hans‐Joachim; Sybrecht, Gerhard W.; Kirsch, Carl-Martin; Hellwig, Dirk

doi:10.1007/s00259-010-1387-3

Cited by 76 publications

(60 citation statements)

References 33 publications

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“…18 F-FDG PET/CT has been examined in the context of prognostic evaluation of a variety of different malignancies. Disease activity is usually measured by determining the SUVmax, which represents the point of highest metabolic activity within the tumor and has been used for prognosis and therapy guidance in many neoplastic diseases (29)(30)(31)(32)(33)(34). In our study, SUVmax alone did not predict disease progression or death.…”

Section: Discussionmentioning

confidence: 59%

Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Fonti

Larobina

Vecchio³

et al. 2012

J Nucl Med

163

117

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18 F-FDG PET/CT allows the direct measurement of metabolic tumor burden in a variety of different malignancies. The aim of this study was to assess whether metabolic tumor volume (MTV) determined by 18 F-FDG PET/CT could be used in the prediction of progression-free and overall survival in multiple myeloma patients. Methods: Forty-seven patients (18 women, 29 men; mean age 6 SD, 63 6 11 y) with stage IIIA disease who had undergone whole-body 18 F-FDG PET/CT were retrospectively evaluated. Images underwent a 3-dimensional region-of-interest analysis including all focal lesions with a maximum standardized uptake value . 2.5. The MTV of each lesion was calculated using an automated contouring program based on the standardized uptake value and developed with a threshold of 40% of the maximum standardized uptake value. The total MTV of each patient was defined as the sum of metabolic volume of all focal lesions. Patients were treated and then subjected to a mean follow-up period of 24 mo. Results: In the 47 patients studied, MTV range was 1.3-316.3 mL, with a median of 23.7 mL. A direct, significant correlation was found between MTV and the percentage of diffuse infiltration of bone marrow by plasma cells (r 5 0.46, P 5 0.006), whereas hemoglobin levels were inversely correlated with MTV (r 5 20.56, P 5 0.0001). At follow-up, patients who developed progressive disease (n 5 18) showed a significantly higher MTV (74.7 6 19.3 vs. 29.8 6 5.1 mL, P 5 0.009) than patients without progressive disease (n 5 29). Furthermore, patients who died of myeloma (n 5 9) had a significantly higher MTV (123.2 6 30.6 vs. 28.9 6 4.2 mL, P 5 0.0001) than survivors (n 5 38). No differences in age, plasma cell infiltration, M protein, albumin, b2-microglobulin, performance status, International Staging System score, and presence or absence of a bone marrow transplant were found between groups. The MTV cutoff level was determined by receiver-operating-characteristic curve analysis, and the best discriminative value found for predicting progression-free and overall survival was 42.2 and 77.6 mL, respectively. By Kaplan-Meier analysis and log-rank testing, progression-free and overall survival at follow-up were significantly better in patients showing an MTV lower than the cutoff than in those having an MTV higher than the cutoff (x 2 5 3.9, P 5 0.04, and x 2 5 56.3, P , 0.0001, respectively). Conclusion: The direct measurement of tumor burden obtained by calculating MTV on 18 F-FDG PET/CT images may be used in the prediction of progression-free and overall survival in myeloma patients.

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Section: Discussionmentioning

confidence: 59%

Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Fonti

Larobina

Vecchio³

et al. 2012

J Nucl Med

163

117

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“…6,39 Among more recent studies identifi ed by our updated literature review, estimates of sensitivity ranged from 72% to 94% ( Table S7 ). [49][50][51][52][53][54] A limitation of most studies of diagnostic accuracy is the use of a single threshold for distinguishing malignant from benign nodules. A prospective study of 344 US veterans with lung nodules addressed this limitation by reporting LRs ratios for fi ve different categories of PET results.…”

Section: Pet Scanning With Fluorodeoxyglucosementioning

confidence: 99%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,120

1,089

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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“…However, specific morphological features are useful in determining malignant potential and among these, nodule attenuation is an important morphological pattern. The maximum standardized uptake value (SUVmax) of 18-fluorine fluorodeoxyglucose positron emission tomography combined with computed tomography ( 18 F-FDG-PET/CT) more than 2.5 is used frequently as a cut off for malignancy (7). The aim of this study is to evaluate 18 F-FDG-PET/CT SUVmax and MSCT pulmonary density (solid vs. subsolid) in SPN patient according to their morphological and pathological patterns, in order to establish the radiological targeted features of malignancy.…”

Section: Introductionmentioning

confidence: 99%

Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: our experience on 1,592 patients

Divisi¹,

Barone²,

Bertolaccini³

et al. 2017

J. Thorac. Dis.

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was considered for the evaluation of nodules, the maximum standardized uptake value (SUVmax) more than 2.5 is used frequently as a cut off for malignancy. The purpose of this study is to evaluate SUVmax PET/CT and pulmonary attenuation patterns at MSCT in patients with SPN according to morphological and pathological characteristics of the lesion.Methods: A retrospective study on 1,592 SPN patients was carried out following approval by the Italian Registry of VATS Lobectomies.Results: All patients underwent VATS lobectomy. On histologic examination, 98.1% had primary or second metachronous primary lung cancers. In addition, 10.7% presented occult lymph node metastases (pN1 or pN2) on histological examination. Nodule attenuation on CT was associated with the histology of the lesion (p= 0.030); in particular, pure ground glass opacities (pGGOs) and partially solid nodules were related to adenocarcinomatous histotypes. Conversely, a significant relationship between SUVmax and age, nodule size, pathological node status (pN) was found (P=0.007, P=0.000 and P=0.002 respectively).Conclusions: Nodule attenuation can predict the histology of the lesion whereas SUVmax may relate to the propensity to lymph node metastases.

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Risk stratification of solitary pulmonary nodules by means of PET using 18F-fluorodeoxyglucose and SUV quantification

Cited by 76 publications

References 33 publications

Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: our experience on 1,592 patients

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Risk stratification of solitary pulmonary nodules by means of PET using 18F-fluorodeoxyglucose and SUV quantification

Cited by 76 publications

References 33 publications

Metabolic Tumor Volume Assessed by 18F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Metabolic Tumor Volume Assessed by 18F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Standardized uptake value and radiological density attenuation as predictive and prognostic factors in patients with solitary pulmonary nodules: our experience on 1,592 patients

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Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma

Metabolic Tumor Volume Assessed by ¹⁸F-FDG PET/CT for the Prediction of Outcome in Patients with Multiple Myeloma