TY - JOUR
T1 - Prognostic and diagnostic value of [18F]FDG-PET/CT in restaging patients with small cell lung carcinoma
T2 - an Italian multicenter study
AU - Young AIMN Working Group
AU - Quartuccio, Natale
AU - Evangelista, Laura
AU - Alongi, Pierpaolo
AU - Caobelli, Federico
AU - Altini, Corinna
AU - Cistaro, Angelina
AU - Lambertini, Alessandro
AU - Schiorlin, Ilaria
AU - Popescu, Cristina E
AU - Linguanti, Flavia
AU - Laudicella, Riccardo
AU - Scalorbi, Federica
AU - Di Pierro, Giulia
AU - Asabella, Artor N
AU - Cuppari, Lea
AU - Margotti, Simone
AU - Lima, Giacomo M
AU - Scalisi, Salvatore
AU - Pacella, Sara
AU - Kokomani, Aurora
AU - Ciaccio, Alfonso
AU - Sturiale, Letterio
AU - Vento, Antonio
AU - Cardile, Davide
AU - Baldari, Sergio
AU - Panareo, Stefano
AU - Fanti, Stefano
AU - Rubini, Giuseppe
AU - Schillaci, Orazio
AU - Chiaravalloti, Agostino
PY - 2019/8
Y1 - 2019/8
N2 - BACKGROUND: The presence of residual disease after initial treatment in small cell lung cancer (SCLC) influences prognosis and impacts patient management. To date, few data exist on the value of fluorine-18-fluorodeoxyglucose ([F]FDG)-PET/computed tomography (CT) in SCLC at restaging. Therefore, in restaging patients with SCLC, we aimed to (a) evaluate the prognostic value yielded by [F]FDG-PET/CT and (b) assess the diagnostic agreement between [F]FDG-PET/CT and contrast-enhanced computed tomography (ceCT).PATIENTS AND METHODS: From a multicenter database, we evaluated 164 patients with SCLC who underwent [F]FDG-PET/CT for restaging purposes. PET scans were evaluated visually to identify the presence of recurrence. For each patient, the maximum and the mean standardized uptake value (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis were calculated, taking into account the lesion with the highest [F]FDG uptake (namely, the index lesion) in the local recurrences, lymph node involvement, and distant metastasis categories. Kaplan-Meier curves were computed to assess the effects of [F]FDG-PET/CT findings on overall survival (OS) and progression-free survival. Furthermore, the agreement between PET/CT and ceCT in detecting metastases was evaluated in 119 patients on a patient-based analysis (Cohen's κ; P < 0.05).RESULTS: The presence of metastatic lesions at [F]FDG-PET/CT was associated with a significantly shorter OS (P = 0.039) and progression-free survival (P < 0.001). Higher SUVmax showed a trend toward a shorter OS (P = 0.065). The K-agreement between ceCT and PET/CT in recurrent SCLC was 0.37 (P < 0.001). PET/CT and ceCT showed the same number of lesions in 52 (43.7%) patients, whereas PET/CT detected additional lesions in 35 (29.4%) patients.CONCLUSION: Detection of metastatic lesions at restaging by [F]FDG-PET/CT can predict a higher rate of progression and negatively influence OS in patients with SCLC. [F]FDG-PET/CT and ceCT seem to be complementary imaging modalities in patients with metastatic SCLC.
AB - BACKGROUND: The presence of residual disease after initial treatment in small cell lung cancer (SCLC) influences prognosis and impacts patient management. To date, few data exist on the value of fluorine-18-fluorodeoxyglucose ([F]FDG)-PET/computed tomography (CT) in SCLC at restaging. Therefore, in restaging patients with SCLC, we aimed to (a) evaluate the prognostic value yielded by [F]FDG-PET/CT and (b) assess the diagnostic agreement between [F]FDG-PET/CT and contrast-enhanced computed tomography (ceCT).PATIENTS AND METHODS: From a multicenter database, we evaluated 164 patients with SCLC who underwent [F]FDG-PET/CT for restaging purposes. PET scans were evaluated visually to identify the presence of recurrence. For each patient, the maximum and the mean standardized uptake value (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis were calculated, taking into account the lesion with the highest [F]FDG uptake (namely, the index lesion) in the local recurrences, lymph node involvement, and distant metastasis categories. Kaplan-Meier curves were computed to assess the effects of [F]FDG-PET/CT findings on overall survival (OS) and progression-free survival. Furthermore, the agreement between PET/CT and ceCT in detecting metastases was evaluated in 119 patients on a patient-based analysis (Cohen's κ; P < 0.05).RESULTS: The presence of metastatic lesions at [F]FDG-PET/CT was associated with a significantly shorter OS (P = 0.039) and progression-free survival (P < 0.001). Higher SUVmax showed a trend toward a shorter OS (P = 0.065). The K-agreement between ceCT and PET/CT in recurrent SCLC was 0.37 (P < 0.001). PET/CT and ceCT showed the same number of lesions in 52 (43.7%) patients, whereas PET/CT detected additional lesions in 35 (29.4%) patients.CONCLUSION: Detection of metastatic lesions at restaging by [F]FDG-PET/CT can predict a higher rate of progression and negatively influence OS in patients with SCLC. [F]FDG-PET/CT and ceCT seem to be complementary imaging modalities in patients with metastatic SCLC.
KW - Adult
KW - Disease-Free Survival
KW - Female
KW - Fluorodeoxyglucose F18
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Italy
KW - Kaplan-Meier Estimate
KW - Male
KW - Neoplasm Staging
KW - Neoplasms/diagnostic imaging
KW - Positron Emission Tomography Computed Tomography
KW - Retrospective Studies
KW - Small Cell Lung Carcinoma/diagnostic imaging
U2 - 10.1097/MNM.0000000000001038
DO - 10.1097/MNM.0000000000001038
M3 - Article
C2 - 31136534
VL - 40
SP - 808
EP - 814
JO - Nuclear Medicine Communications
JF - Nuclear Medicine Communications
SN - 0143-3636
IS - 8
ER -