Role of Various Metabolic Parameters Derived From Baseline 18F-FDG PET/CT as Prognostic Markers in Non–Small Cell Lung Cancer Patients Undergoing Platinum-Based Chemotherapy

Sharma, Anubhuti; Mohan, Anant; Bhalla, Ashu Seith; Sharma, Mehar Chand; Sreenivas, Vishnubhatla; Das, Chandan Jyoti; Pandey, Anil Kumar; Bal, Chandra Sekhar; Patel, Chetan; Sharma, Punit; Agarwal, Krishan Kant; Kumar, Rakesh

doi:10.1097/rlu.0000000000001886

Cited by 53 publications

(48 citation statements)

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“…This may be due to the fact that SUVmax-T only represented a few pixels instead of the whole tumour. Studies showed that among PET biomarkers, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) both re ect the metabolic tumor burden and are considered to be the strongest prognostic factors, even more so than tumoral maximal standardized uptake values (SUVmax) [13]. Some studies have shown that MTV or TLG, after taking the tumour size into consideration, are better prognostic predictors than SUVmax alone [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…A few studies have focused on the correlation of metabolic parameters such as the standard uptake values (SUVs) of gross tumours and survival outcomes in patients with ESCC but have reached controversial conclusions. A meta-analysis that included 10 studies concluded that a high maximum of standard uptake value (SUVmax) of the primary tumour predicted a poor overall survival with a hazard ratio of 1.86 (95%CI,1.53-2.27), but the cut-point to de ne a high SUV ranged widely in these studies (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) [6]. A multi-centre prospective study reported that the SUV of the baseline gross tumour had a negative prognostic value in oesophageal cancer patients [7].…”

Section: Introductionmentioning

confidence: 99%

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Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

Ren¹,

Chen²,

Chen³

et al. 2020

Preprint

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Background: To investigate the prognostic value of 18F–fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in esophagus squamous cell carcinoma (ESCC), PET/CT imaging characteristics were explored in the present study.Methods: Baseline PET/CT and clinical characteristics were collected in 125 patients with ESCC treated with radical radiotherapy from 2007–2016. The maximum standardized uptake value (SUVmax) of the primary gross tumour (SUVmax-T) and metastatic lymph node (SUVmax-N) were separately measured using X-tile. Overall survival (OS) and progression free survival (PFS) were estimated according to the Kaplan–Meier method. A multivariate Cox model was used to establish the independent prognostic factors.Results: The gross tumours presented higher 18F-FDG uptake than normal tissues with a median SUVmax-T of 12.5. The OS and PFS did not show significant differences between patients with SUVmax-T ≥ 12.5 and those with SUVmax-T <12.5 (P>0.05). However, patients with SUVmax-N ≥ 11 had a significantly worse OS and PFS than those with SUVmax-N <11 (P<0.05). A weak correlation was observed in SUVmax-T and SUVmax-N. The OS and PFS of patients with PET-negative LNs was significantly better than those with PET-positive LNs. However, the OS and PFS of patients with one or two PET-positive LNs were not significantly better than those with more than two PET-positive LNs. In the univariate analysis, cT stage, positive or negative lymph nodes on the PET-CT image and the SUVmax-N were established as significant prognostic factors for both OS and PFS. In multivariate analysis, SUVmax-N was proved to be an independent predictor for OS and PFS.Conclusions: SUVmax-N, but not SUVmax-T, is an independent prognostic indicator for patients with ESCC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

Ren¹,

Chen²,

Chen³

et al. 2020

Preprint

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“…The FDG‐PET is a superior modality for detecting malignant lesions in the digestive tract and other sites 15, 16, 17, 18, 19. FDG‐PET can be used for imaging of tumor activity by reflecting glucose metabolism; rarely, it can also be used to obtain a functional imaging diagnosis of malignancy.…”

Section: Discussionmentioning

confidence: 99%

¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

et al. 2018

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18F‐Fluorodeoxyglucose positron emission tomography (FDG‐PET) is a useful imaging modality that reflects the tumor activity. However, FDG‐PET is mainly used for advanced cancer, not superficial cancer. In this study, we investigated the relationship between the superficial tumor depth of esophageal cancer and the FDG uptake to determine the indications for endoscopic resection (ER). From 2009 to 2017, 444 patients with esophageal cancer underwent esophagectomy or endoscopic submucosal dissection (ESD), and 195 patients were pathologically diagnosed with superficial cancer. Among them, 146 patients were examined by FDG‐PET before esophagectomy or ESD. In these 146 patients, the relationship between the pathological tumor depth and FDG uptake was analyzed. The mean maximum standardized uptake value in pT1a‐EP/LPM tumors was 1.362 ± 0.890, that in pT1a‐MM/pT1b‐SM1 tumors was 2.453 ± 1.872, and that in pT1b‐SM2/SM3 tumors was 4.265 ± 3.233 (P < .0001). Among 51 pT1a‐EP/LPM tumors, 10 (19.6%) showed positive detection of FDG. For pT1a‐MM/pT1b‐SM1 and pT1b‐SM2/SM3 tumors, the detection rate was 52.9% (18/34) and 82.0% (50/61), respectively. The detection rate of pT1a‐EP/LPM was significantly lower than in the other two groups (P < .0001). Among 10 FDG‐PET‐positive lesions, only 1 had no apparent reason for PET positivity; however, 9 of 10 had a suitable reason for detectability by PET and inadequacy for ER. Negative detection of superficial esophageal squamous cell carcinoma by FDG‐PET is useful to determine the indication for ER when the tumor depth cannot be diagnosed even after performing magnifying endoscopy with narrow band imaging and endoscopic ultrasonography. When FDG uptake is recognized, a therapeutic modality other than ER should be considered.

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“…The largest study (311 patients, UICC stage I-III) further showed that ASP, with an optimal cut-off of > 19.5%, could identify patients with UICC stage II treated by surgery and adjuvant chemotherapy with high ASP and reduced PFS (median, 11 months vs. not reached) and OS (22 months vs. not reached) (15). ASP was superior for survival prediction compared to primary tumor's maximum standardized uptake value (SUVmax) and MTV, two other previously proposed and common PET parameters (8,9,16,17).…”

Section: Introductionmentioning

confidence: 96%

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

Rogasch

Furth

Bluemel

et al. 2020

Preprint

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Background Asphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) in FDG-PET/CT is independently predictive for survival in patients with non-small cell lung cancer (NSCLC). However, comparability between PET systems may be limited. Therefore, reproducibility of ASP was evaluated at varying image reconstruction and acquisition times to assess feasibility of ASP assessment in multicenter studies. Methods Retrospective study of 50 patients with NSCLC (female, 20; median age, 69 years) undergoing pretherapeutic FDG-PET/CT (median, 3.7 MBq/kg; 180 s/bed position). Reconstruction used OSEM with TOF4/16 (iterations, 4; subsets, 16; in-plane filter, 2.0, 6.4 or 9.5 mm), TOF4/8 (4 it; 8 ss; filter, 2.0/6.0/9.5 mm), PSF + TOF2/17 (2 it; 17 ss; filter, 2.0/7.0/10.0 mm) or Bayesian penalized likelihood (Q.Clear; beta, 600/1750/4000). Resulting reconstructed spatial resolution (FWHM) was determined from hot sphere inserts of a NEMA IEC phantom. Data with approx. 5 mm FWHM were retrospectively smoothed to achieve 7 mm FWHM. List mode data were rebinned for acquisition times of 120/90/60 s. Threshold-based delineation of primary tumor MTV was followed by evaluation of relative ASP/SUVmax/MTV differences between datasets and resulting proportions of discordantly classified cases. Results Reconstructed resolution for narrow/medium/wide in-plane filter (or low/medium/high beta) was approx. 5/7/9 mm FWHM. Comparing different pairs of reconstructed resolution between TOF4/8, PSF + TOF2/17, Q.Clear and the reference algorithm TOF4/16, ASP differences were lowest at FWHM of 7 vs. 7 mm. Proportions of discordant cases (ASP > 19.5% vs. ≤19.5%) were also lowest at 7 mm (TOF4/8, 2%; PSF + TOF2/17, 4%; Q.Clear, 10%). Smoothing of 5 mm data to 7 mm FWHM significantly reduced discordant cases (TOF4/8, 38% reduced to 2%; PSF + TOF2/17, 12–4%; Q.Clear, 10–6%) resulting in proportions comparable to original 7 mm data. Shorter acquisition time only increased proportions of discordant cases at < 90 s. Conclusions ASP differences were mainly determined by reconstructed spatial resolution, and multicenter studies should aim at comparable FWHM (e.g., 7 mm; determined by in-plane filter width). This reduces discordant cases (high vs. low ASP) to an acceptable proportion for TOF and PSF + TOF of < 5% (Q.Clear: 10%). Data with better resolution (i.e. lower FWHM) could be retrospectively smoothed to the desired FWHM resulting in a comparable number of discordant cases.

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Role of Various Metabolic Parameters Derived From Baseline 18F-FDG PET/CT as Prognostic Markers in Non–Small Cell Lung Cancer Patients Undergoing Platinum-Based Chemotherapy

Cited by 53 publications

References 25 publications

Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

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Role of Various Metabolic Parameters Derived From Baseline 18F-FDG PET/CT as Prognostic Markers in Non–Small Cell Lung Cancer Patients Undergoing Platinum-Based Chemotherapy

Cited by 53 publications

References 25 publications

Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

Maximum Standardized Uptake Value in Lymph Nodes Measured by 18F-FDG PET/CT Predicts the Outcome of Patients with Oesophagus Squamous Cell Carcinoma

18F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

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¹⁸F‐Fluorodeoxyglucose positron emission tomography can be used to determine the indication for endoscopic resection of superficial esophageal cancer