Volume-Based Parameter of 18F-FDG PET/CT in Malignant Pleural Mesothelioma: Prediction of Therapeutic Response and Prognostic Implications

Abstract

Volume-based parameters of (18)F-FDG PET/CT have the potential to provide prognostic information in MPM patients who are receiving surgery or palliative chemotherapy.

Correlation between Semi-Quantitative 18F-FDG PET/CT Parameters and Ki-67 Expression in Small Cell Lung Cancer

“…The standardized uptake value (SUV), which is the most popular semiquantitative parameter to objectify PET/CT data, reflects the glucose metabolic rate and is used to characterize tumor metabolism in vivo. Metabolic tumor volume (MTV), defined as the volume of tumor tissue with increased 18 F-FDG uptake, and total lesion glycolysis (TLG), defined as the product of MTV and mean SUV (SUVmean), are also important independent prognostic factors in various cancers [9][10][11][12]. The degree of 18 F-FDG tumor uptake on PET/CT as measured by SUV is correlated with cell proliferative activity as determined by the Ki-67 expression level in patients with NSCLC [13][14][15].…”

Robustness of intratumour 18F-FDG PET uptake heterogeneity quantification for therapy response prediction in oesophageal carcinoma

“…Within the specific context of response to therapy prediction or assessment, PET image derived indices such as metabolically active tumour volumes (MATV), mean standardized uptake values (SUVmean) and derived total lesion glycolysis (TLG, equal to MATV×SUVmean) have been shown to provide a more accurate assessment of tumour burden with potentially higher predictive and prognostic value compared to standard maximum or peak SUV measurements (SUVmax, SUVpeak) for a variety of cancer models including lung [4], esophagus [5], head&neck [6], rectum [7], breast [8], pleural mesothelioma [9] and nonHodgkin lymphomas [10].…”

Volumetric assessment in malignant pleural mesothelioma

“…For MRI, tumor segmentation has been performed using a HASTE (halfFourier single-shot fast spin-echo) sequence, but this can be limited by signal inhomogeneity and motion artifacts, with a segmentation time of 10 minutes described per patient (45). Tumor segmentation on PET/CT allows calculation of the volume of metabolically active tumor by segmenting the volume of interest using an adaptive threshold based on SUV (22,23,38,44). The total glycolytic volume (TGV) is a measure of tumor volume and metabolic activity, with a correlation between TGV and tumor activity (46).…”

“…The total glycolytic volume (TGV) is a measure of tumor volume and metabolic activity, with a correlation between TGV and tumor activity (46). Measurement of the volume of metabolically active tumor on 18 F-FDG PET/CT was incorporated into a prognostic model, incorporating both tumor volume and glycolysis, termed TGV (22,38). SUV alone did not significantly predict survival, suggesting that tumor volume provides the main prognostic information (22).…”