FDG-PET/CT parameters as predictors of outcome in inoperable NSCLC patients

Antonio Nappi, Rosj Gallicchio, Vittorio Simeon, Anna Nardelli, Alessandra Pelagalli, Angela Zupa, Giulia Vita, Angela Venetucci, Michele Di Cosola, Francesco Barbato, Giovanni Storto

Research output: Contribution to journalArticlepeer-review

Abstract

Background. We evaluated the prognostic significance of standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) in [F-18] FDG PET/CT findings in patients with inoperable non-small-cell lung cancer (NSCLC). Patients and methods. One hundred and three patients (mean age, 65.6 ± 16 years) underwent [F-18] FDG PET/CT before the chemotherapy. The SUVmax value, the MTV (cm3; 42% threshold) and the TLG (g) were registered. The patients were followed up to 18 months thereafter (range 12-55 months). Failure to respond without progression, progression and/or disease-related death constituted surrogate end-points. The optimal SUVmax, MTV and TLG cut-off to predict the patients' outcome were estimated. PET/CT results were then related to disease outcome (progression free survival; PFS). Results. The Kaplan-Meier survival analysis for SUVmax showed a significant shorter PFS in patients presenting with lower values as compared to those with higher (p <0.05, log-rank test). MTV and TLG were not suitable for predicting PFS apart from the subset of patients with mediastinal nodal involvement. Conclusions. Despite the availability of new tools for the quantitative assessment of disease activity on PET/CT, the SUVmax rather than MTV and TLG remains the only predictor for PFS in NSCLC patients. MTV holds a value only when concomitant nodal involvement occurs.

Original languageEnglish
Pages (from-to)320-326
Number of pages7
JournalRadiology and Oncology
Volume49
Issue number4
DOIs
Publication statusPublished - Dec 1 2015

Keywords

  • glycolytic activity
  • Non-small-cell lung cancer
  • quantitative assessment
  • survival
  • [F-18] FDG PET/CT

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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