The Ratio of Lymph Node to Primary Tumor SUV on PET/CT Accurately Predicts Nodal Malignancy in Non-Small Cell Lung Cancer

Lou

et al. 2022

Preprint

Background: To evaluate the prognostic value of the ratio of the standard uptake value of the lymph node to the primary tumor before treatment of locally advanced nasopharyngeal carcinoma.Methods: A total of 180 patients with locally advanced nasopharyngeal carcinoma diagnosed pathologically from January 1, 2016, to December 31, 2018, were selected, and the MEDEX system was used to automatically delineate lymph node metastases SUVmax (LN-SUVmax) and nasopharyngeal carcinoma primary tumor SUVmax (T-SUVmax). In addition, the ratio NTR of LN-SUVmax to T-SUVmx was calculated, and an ROC curve was drawn to obtain the best cut-off value. Kaplan–Meier and Cox regression models were used for survival and multivariate analyses, respectively.Results: The median follow-up period of 180 patients was 32 (4–62) months. Univariate analysis showed that age (P = 0.013), LN-SUVmax (P = 0.001), and NTR (P = 0.001) were factors influencing overall survival (OS). Factors affecting local progression-free survival (LPFS) were LN-SUVmax (P = 0.005) and NTR (P = 0.020), while clinical stage (P = 0.023), LN-SUVmax (P = 0.007), and NTR (P = 0.032) were factors affecting Distant metastasis-free survival (DMFS). Multivariate analysis showed that NTR was an independent influencing factor of OS (HR = 3.00, 95%CI = 1.06–8.4, P = 0.038), LPFS (HR = 3.08, 95%CI = 1.27–7.50, P = 0.013), and DMFS (HR = 1.84, 95%CI = 0.99–3.42, P = 0.054). Taking OS as the main observation point, the best cut-off point of NTR was 0.95. Kaplan–Meier results showed that the 3-year OS (97.0% vs. 85.4%, c2=11.25, P = 0.001), 3-year LPFS (91.3% vs. 82.1%, c2 = 4.035, P = 0.045), and 3-year DMFS (92.3% vs. 87.9%, c2 = 4.576, P = 0.032) of patients with NTR < 0.95 were higher than those with NTR > 0.95.Conclusions: High NTR before treatment may lead to poor prognosis of patients with nasopharyngeal carcinoma. This can serve as a reference value for the reasonable treatment and prognosis monitoring of such patients.

Section: Discussionmentioning

confidence: 99%

The prognostic value of the ratio of standard uptake value of lymph node to primary tumor before treatment of locally advanced nasopharyngeal carcinoma

Lou

et al. 2022

Preprint

“…PET-CT SUV, as an indicator reflecting metabolic activity of tumor lesion, has also been reported and considered as a prognostic factor in many studies [16][17][18]. However, currently there is no evidence that SUV was correlated with bevacizumab treatment response.…”

Section: Discussionmentioning

confidence: 99%

PET-CT Standard uptake value predict bevacizumab-containing chemotherapy response and prognosis for unresectable colorectal cancer liver-limited metastasis

Yang

Feng

Tang

et al. 2019

Preprint

Background: Standard uptake value (SUV) is an indicator of tumor metabolic response. In this paper, we aim to explore the value of SUV on unresectable colorectal cancer liver-limitedmetastasis (CRLM) patients receiving bevacizumab-containing chemotherapy. Method: This study was performed retrospectively. A total of 185 CRLM patients between April 2011 to December 2015 with complete clinical data were included in this study. All enrolled patients were assigned into two treatment cohorts (bevacizumab plus chemotherapy cohort and chemotherapy only cohort). All clinical variables, and various PET/CT parameters were statistically compared with progression-free survival (PFS) and overall survival (OS). Primary and Metastatic tumor SUV were selected for analysis. Results: Among the 185 patients, 101 patients received chemotherapy plus bevacizumab ( beva cohort ), 84 patients only received chemotherapy ( CMT cohort ). Baseline characteristics of two cohorts showed no statistical difference (P>0.05). Primary SUV level was correlated with primary tumor size, while metastatic SUV was statistically correlated with metastatic tumor number and tumor size (P=0.000). Primary lesion, metastatic lesion SUV and elevation of SUV demonstrated prognostic role for OS (P<0.05). SUV gap were statistically associated with optimal response in beva cohort (P=0.03) and no-PD status in CMT cohort (P=0.019), respectively. After multivariate analysis, elevated SUV is an independent risk factor for OS (P=0.000). Besides, elevation of SUV between metastatic and primary lesion can be a predictive factor for bevacizumab survival benefit. Conclusion: PET-CT scan is important for CRLM patients. Our study demonstrated that an elevation of SUV was a better prognostic and predictive marker for CRLM patients.

“…As a result of the widespread application of 18F-FDG PET/ CT, these techniques are now used to detect regional lymph node metastasis in a variety of malignant neoplasms (30)(31)(32).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of the accuracy of 18F-FDG PET/CT for detection of regional lymph node metastasis in esophageal squamous cell carcinoma

Jiang¹,

Chen²,

Zhu³

et al. 2018

J. Thorac. Dis

Background: We performed a systematic review and meta-analysis to assess the accuracy of 18F-fluorodeoxyglucose positron emission tomography with computer tomography (18F-FDG PET/CT) for detection of regional lymph node metastasis in esophageal squamous cell carcinoma in per-patient and per-nodal station basis. Methods: Electronic databases were researched for studies assessing the sensitivity and specificity of PET/ CT to detect the regional lymph node metastasis published between January 2006 and December 2017 on esophageal squamous cell carcinoma. STATA software was performed to assess the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odd ratio (DOR) and summary receiver operating characteristic (SROC) curve. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) and Deeks' Funnel Plot Asymmetry Test were performed to evaluate the study quality and publication bias of included studies. Results: Nineteen studies were eligible for meta-analysis, comprising 1,089 patients with esophageal cancer who underwent 18F-FDG PET/CT before surgery. According to the content of the article, we divided the selected studies into per-patient basis group and per-nodal basis group (one of the articles was involved in both groups). For the per-nodal station basis group (12 studies, 5,681 stations), the pooled sensitivity and specificity estimates of 18F-FDG PET/CT for detecting regional lymph node metastasis were 66% [95% confidence interval (CI): 51-78%] and 96% (95% CI: 92-98%), respectively. The corresponding values on a per-patient basis group (8 studies; 506 patients) were 65% (95% CI: 49-78%) and 81% (95% CI: 69-89%) in sensitivity and specificity, respectively. Conclusions: Overall, 18F-FDG PET/CT have a moderate to low sensitivity and a high to moderate specificity for detection of regional nodal metastasis in esophageal cancer. Therefore, since the false rate is considerable, extending the extent of lymph node dissection or radiotherapy target volume is necessary after diagnosis of regional nodal metastasis by 18F-FDG PET/CT.