Total lesion glycolysis by 18F-FDG PET/CT is a reliable predictor of prognosis in soft-tissue sarcoma

Choi, Eun Seok; Ha, Seung Gyun; Kim, Han‐Soo; Ha, Jae Hong; Paeng, Jin Chul; Han, Ilkyu

doi:10.1007/s00259-013-2511-y

Cited by 86 publications

(76 citation statements)

References 19 publications

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“…Additionally, UVP was calculated to consider both degree and volume of uptake. This approach is widely used in oncologic PET studies to quantify the overall metabolic burden of tumors (26,27). In the present study, UVP that reflects the overall angiogenic activity showed the most significant correlation with P Bas and P Str improvement among all the indices.…”

Section: Discussionsupporting

confidence: 48%

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

et al. 2014

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Indirect revascularization is the most widely used treatment to induce angiogenesis in pediatric moyamoya disease (MMD). Molecular imaging methods targeted for angiogenesis have recently been developed. We performed angiogenesis imaging in indirect revascularization surgery for MMD to evaluate angiogenic activity and its correlation with treatment efficacy. Methods: Twelve patients with pediatric MMD were prospectively enrolled. Encephaloduroarteriosynangiosis surgery was conducted, and 68 Ga-ArgGly-Asp (RGD) PET was performed 3.7 ± 1.0 mo after surgery. Basal perfusion and stress perfusion (P Str ) in the middle cerebral artery territory were evaluated by acetazolamide-stress brain perfusion SPECT using statistical probabilistic anatomic mapping, at preoperative, early postoperative, and long-term follow-up states. Angiogenic activity was assessed on the images in terms of maximal uptake ratio, volume of increased uptake, and uptake-volume product. Results: Basal perfusion and P Str were significantly improved after surgery. Increased angiogenic activity was observed in the revascularized area, mainly around the bony flap. Angiogenic activity gradually decreased with time and significantly correlated with the postoperative time interval (P 5 0.0015 for maximal uptake ratio and 0.0069 for volume of increased uptake). It was estimated to normalize at 6.3 mo after surgery. Uptake-volume product was inversely correlated with P Str improvement at the early postoperative state (r 5 −0.5960, P 5 0.0409) and also weakly correlated with P Str improvement at long-term follow-up (r 5 −0.5010, P 5 0.1165). Conclusion: Angiogenesis PET imaging with 68 Ga-RGD was successfully used for the assessment of angiogenic activity in indirect revascularization surgery for MMD, and angiogenic activation measured at approximately 3.7 mo after surgery was inversely correlated with perfusion improvement. The assessment of angiogenic activity using 68 Ga-RGD PET is expected to be effective for evaluating the mechanism or efficacy of revascularization treatment.

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Section: Discussionsupporting

confidence: 48%

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

et al. 2014

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“…In a study of 55 soft tissue sarcoma patients including 7 synovial sarcoma cases, the SUVmax of the primary tumor was the only significant independent metabolic prognostic factor for OS, and the other volume-based PET parameters did not provide prognostic information [35]. Also, another study in 66 patients with soft tissue sarcoma including 6 synovial sarcoma cases demonstrated that the TLG was a more accurate predictor of disease progression than SUVmax or MTV [36]. There have been no reported studies using only synovial sarcoma for evaluating the prognostic factors of metabolic PET parameters.…”

Section: Discussionmentioning

confidence: 99%

The Role of 18F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma

Chang

Lim

Park

et al. 2014

Nucl Med Mol Imaging

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Purpose This research aims to investigate the potential of 18 Ffluorodeoxyglucose positron emission tomography/computed tomography (FDG PET) to predict pathologic response after neoadjuvant chemotherapy (NAC) and overall survival (OS) of patients with synovial sarcoma in Korea. Methods Twenty patients with synovial sarcoma from January 2001 to December 2011 were reviewed retrospectively. All patients underwent pre-treatment FDG PET and tumor removal. Patients were classified with the maximum SUV (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), age, sex, histologic subtype, tumor size, NAC, resection margin, and metastasis at diagnosis. Pathologic response was assessed using the French Federation of Cancer Centers system. Statistical analyses were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards regression model, and Mann-Whitney test. Results Nine patients (45 %) showed pathologic response, and ten patients survived. Higher SUVmax, higher MTV, higher TLG, monophasic epithelial type, and metastasis at diagnosis were significantly related to poorer OS (p=0.047, 0.016, 0.016, 0.045, and 0.018, respectively). By multivariate analysis, metastasis at diagnosis was significantly related to poorer OS (p=0.012/HR=5.9, 95 % CI 1.47 to 24.1). The SUVmax, MTV, and TLG of the non-responder group were significantly higher than those of the responder group (p= 0.020, 0.020, and 0.020, respectively). There was no significant difference in size between the two groups (p=0.062). Conclusions A higher SUVmax on the pre-treatment scan, monophasic epithelial type, and metastasis at diagnosis were significantly associated with a poorer OS, and pathologic responders showed a higher SUVmax before NAC. The PET parameters can be used to predict OS and pathologic response in patients with synovial sarcomas before NAC.

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“…In addition to metabolic activity indices such as SUV and TBR, volumetric indices are now widely used to analyze 18 F-FDG PET/ CT results for various cancers (15)(16)(17)(18). MTV is defined as the volume of tissue that exhibits a higher metabolism over a certain threshold, and total lesion uptake, or total lesion glycolysis, is defined as MTV multiplied by SUV mean .…”

Section: Discussionmentioning

confidence: 99%

“…Metabolic tumor volume (MTV) and total lesion uptake on PET/CT are effective indices, particularly in terms of prognosis prediction and treatment response monitoring (15)(16)(17)(18). These volumetric indices are also expected to be effective in recurrence prediction after liver transplantation for HCC, because the indices consider tumor burden.…”

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Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT

et al. 2016

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18 F-FDG PET is an effective method of predicting recurrence of hepatocellular carcinoma (HCC) after liver transplantation. We compared recently introduced metabolic and volumetric 18 F-FDG PET/ CT indices with the current clinicopathologic predictors for ability to predict recurrence. Methods: In total, 110 HCC patients who underwent 18 F-FDG PET and liver transplantation were enrolled. On PET, SUVs and tumor-to-background ratios (TBRs) were measured as metabolic activity indices. Various metabolic tumor volumes and uptake-volume products (UVP) were also measured as volumetric indices. The ability of these indices and other clinicopathologic factors to predict recurrence was compared. Results: All metabolic and volumetric indices were significant for recurrence prediction on receiver-operating-characteristic curve analyses (P , 0.001). On univariate survival analyses, all PET indices-as well as tumor size, tumor number, the Milan criteria, tumor grade, vascular invasion, and T-stage-were significant factors. However, on multivariate analyses, tumor size, tumor grade, maximum TBR, and UVP calculated by inferior vena cava activity were significant factors (P 5 0.004, 0.014, 0.009, and 0.021, respectively). When the Milan criteria and PET factors were included in the multivariate analysis, the Milan criteria (P 5 0.029), maximum TBR (P , 0.001), and UVP (P 5 0.016) were significant. Conclusion: Volumetric and metabolic activity indices of 18 F-FDG PET are effective predictors of posttransplantation HCC recurrence. In addition to clinicopathologic factors, these indices need to be considered in the selection of candidates for liver transplantation.

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Total lesion glycolysis by 18F-FDG PET/CT is a reliable predictor of prognosis in soft-tissue sarcoma

Abstract: TLG is a more accurate predictor of disease progression than SUVmax or MTV. TLG enables accurate preoperative assessment of aggressiveness comparable with conventional clinicopathological parameters.

Cited by 86 publications

References 19 publications

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

The Role of 18F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma

Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT

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Total lesion glycolysis by 18F-FDG PET/CT is a reliable predictor of prognosis in soft-tissue sarcoma

Abstract: TLG is a more accurate predictor of disease progression than SUVmax or MTV. TLG enables accurate preoperative assessment of aggressiveness comparable with conventional clinicopathological parameters.

Cited by 86 publications

References 19 publications

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

In Vivo Evaluation of Angiogenic Activity and Its Correlation with Efficacy of Indirect Revascularization Surgery in Pediatric Moyamoya Disease

The Role of 18F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma

Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of 18F-FDG PET/CT

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Prediction of Posttransplantation Recurrence of Hepatocellular Carcinoma Using Metabolic and Volumetric Indices of ¹⁸F-FDG PET/CT