The potential value of volume-based quantitative PET parameters and increased bone marrow uptake for the prediction of survival in patients with malignant pleural mesothelioma

Abstract

The presence of distant metastasis is more predictive of survival than PET nodal status in MPM patients. PET/CT has the potential to provide prognostic information in MPM patients and there was a good correlation between overall survival and volume-based PET parameters. Determination of BM uptake may contribute toward the prediction of patient outcome with other quantitative PET parameters.

Development of a Novel Prognostic Risk Classification System for Malignant Pleural Mesothelioma

“…24 Volume-based parameters such as TLG, which incorporate both total tumor volume and metabolic activity, can reflect changes throughout the entire tumor mass. [18][19][20][21][22][23][24] As MPM spreads while generating specific features, including diffuse, complex, and inhomogeneous tumor geometry, TLG can provide significant additional information over the single-pixel analysis provided by SUVmax. We note here that TLG was confirmed as an independent prognostic factor in this current study and was carried over into the risk classification scoring system.…”

“…It is interesting that each predictor we identified here had previously been individually reported as significant, but they have never been systematically combined and integrated into a new scoring system. [18][19][20][21][22][23][24][25][26][27][28][29][30]33 After systematically considering our various predictors together, our prognosis system steadily emerged as shown in Figure 1. To the best of our knowledge, this is the first report to offer a risk classification system that is able to comprehensively focus on the tumor environment of MPM.…”

“…In recent reports, some volume-based quantitative parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on FDG-PET/computed tomography (CT) have been reported to have material prognostic capability for patients with MPM. [18][19][20][21][22][23][24] Because a morphologic diagnosis based only on imaging is challenging, previous studies have focused on the predictive biomarkers of survival in patients with MPM. For example, the neutrophil-to-lymphocyte ratio (NLR) and the serum lactate dehydrogenase (LDH) level have been reported to be associated with the accurate prognosis of patients with MPM.…”

Relation between neutrophil/lymphocyte ratio and primary tumor metabolic activity in patients with malign pleural mesothelioma

“…In recent studies, NLR has been determined to be effective in the prediction of prognosis in MPM. 19 In the current study, the median survival time was determined as 23 months for those with SUVmax value <5 and as 13 months for those with SUVmax 5. 15,16 In another study, survival time was determined as 10.5 months in patients with NLR 3 and as 14.9 months in those with NLR <3.…”

“…18 There are studies which have defined a relationship between poor prognosis and bone marrow involvement and quantitative parameters calculated with PET/CT. 19 In the current study, the median survival time was determined as 23 months for those with SUVmax value <5 and as 13 months for those with SUVmax 5. The 1-and 5-year survival rates of patients with SUVmax value <5 were determined to be higher.…”