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      Prediction of 2 years-survival in patients with stage I and II non-small cell lung cancer utilizing 18F-FDG PET/CT SUV quantification

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          Abstract

          Background

          The purpose of the study was to evaluate the correlation between the maximum standardized uptake value (SUVmax), size of primary lung lesion, disease-free survival (DFS) and overall survival (OS) in patients with stage I and II non-small cell lung cancer (NSCLC) in 2 years follow-up.

          Patients and methods.

          Forty-nine patients with stage I–II NSCLC were included in this study. Pre-surgical 2-deoxy-2-[18F]fluoro-D-glucose positron-emission tomography ( 18F-FDG PET/CT) study was performed for all patients. The relationship between SUVmax, tumour size and clinical outcome was measured. The cut-off value for SUVmax and tumour size with the best prognostic significance, probability of DFS and the correlation between SUVmax and the response to therapy were calculated.

          Results

          There was a statistically significant correlation between SUVmax and DFS (p = 0.029). The optimal cut-offs were 9.00 for SUVmax (p = 0.0013) and 30mm for tumour size (p = 0.0028). Patients with SUVmax > 9 and primary lesion size > 30 mm had an expected 2years-DFS of 37.5%, while this rose to 90% if the tumour was <30 mm and/or SUVmax was <9.

          Conclusions

          In stage I-II, SUVmax and tumour size might be helpful to identify the subgroup of patients with high chance for recurrence.

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          Most cited references22

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          FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

          Ronald Boellaard, Mike J. O’Doherty, Wolfgang A. Weber … (2009)
          The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out, interpret, and document quantitative FDG PET/CT examinations, but will concentrate on the optimisation of diagnostic quality and quantitative information.
          Article 0 comments Cited 320 times – based on 0 reviews     Review now
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            Anatomy of SUV. Standardized uptake value.

            Norden Huang (2000)
            Standardized uptake value (SUV) for [F-18]fluorodeoxyglucose (FDG) studies that is commonly used to differentiate malignant from benign tumors and to assess the efficacy of therapy is reviewed as a simplified calculation of the more general modeling approach. Based on such a basis, the merits and limitations of the SUV approach is examined with reference to literature reports on tumor uptake of FDG. Results indicate the complexity and large variation of glucose uptake mechanism in tumors. Consistently performed procedures and more basic studies are needed to improve the utility of FDG SUV.
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              The maximum standardized uptake values on positron emission tomography of a non-small cell lung cancer predict stage, recurrence, and survival.

              Alfred Bartolucci, Astra Bryant, Buddhiwardhan Ohja … (2005)
              We sought to assess whether the standard uptake value of a pulmonary nodule is an independent predictor of biologic aggressiveness. This is a retrospective review of a prospective database of patients with non-small cell lung cancer. Patients had dedicated positron emission tomography scanning with F-18 fluorodeoxyglucose, with the maximum standard uptake value measured. All suspicious nodal and systemic locations on computed tomographic and positron emission tomographic scanning underwent biopsy, and when indicated, resection with complete lymphadenectomy was performed. There were 315 patients. Multivariate analysis showed patients with a high maximum standard uptake value (>/=10) were more likely to have poorly differentiated tumors (risk ratio, 1.5; P = .005) and advanced stage (risk ratio, 1.9; P = .010) and were less likely to have their disease completely resected (risk ratio, 3.7; P = .004). Maximum standard uptake value was the best predictor of disease-free survival (hazard ratio, 2.5; P = .039) and survival (hazard ratio, 2.8; P = .001). Stage-specific analysis showed that patients with stage IB and stage II disease with a maximum standard uptake value of greater than the median for their respective stages had a lower disease-free survival at 4 years ( P = .005 and .044). The actual 4-year survival for patients with stage Ib non-small cell lung cancer was 80% versus 66% ( P = .048), for stage II disease it was 64% versus 32% ( P = .028), and for stage IIIa disease it was 64% versus 16% ( P = .012) for the low and high maximum standard uptake value groups, respectively. The maximum standard uptake value of a non-small cell lung cancer nodule on dedicated positron emission tomography is an independent predictor of stage and tumor characteristics. It is a more powerful independent predictor than the TNM stage for recurrence and survival for patients with early-stage resected cancer. This information might help guide treatment strategies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Radiol Oncol
                Journal ID (iso-abbrev): Radiol Oncol
                Journal ID (publisher-id): RADO
                Title: Radiology and Oncology
                Publisher: Versita, Warsaw
                ISSN (Print): 1318-2099
                ISSN (Electronic): 1581-3207
                Publication date Collection: September 2013
                Publication date (Electronic): 30 July 2013
                Volume: 47
                Issue: 3
                Pages: 219-223
                Affiliations
                [1 ] Positron Emission Tomography Centre IRMET S.p.A., Euromedic inc., Turin, Italy
                [2 ] Nuclear Medicine Unit, Department of Biomedical Sciences and of the Morphological and Functional Images, University of Messina, Messina, Italy
                [3 ] Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
                [4 ] Department of Thoracic Surgery, S. Giovanni Battista Hospital, Turin, Italy
                [5 ] Department of Nuclear Medicine, La Maddalena Hospital, Palermo, Italy
                Author notes
                Correspondence to: Angelina Cistaro, MD, Positron Emission Tomography Centre IRMET S.p.A, V.O. Vigliani 89, Turin 10136, Italy. Phone: +390113160158; Fax: +390113160828; E-mail: a.cistaro@ 123456irmet.com

                Disclosure: No potential conflicts of interest were disclosed.

                Article
                Publisher ID: rado-47-03-219
                DOI: 10.2478/raon-2013-0023
                PMC ID: 3794876
                PubMed ID: 24133385
                SO-VID: 7d8c76f5-96fd-4e6f-a271-3e06296411d2
                Copyright © Copyright © by Association of Radiology & Oncology
                License:

                This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

                History
                Date received : 15 October 2012
                Date accepted : 04 March 2013
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: 2-deoxy-2-[18f]fluoro-d-glucose positron emission tomography,non-small cell lung cancer,maximum standardized uptake value,disease-free survival,overall survival
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: 2-deoxy-2-[18f]fluoro-d-glucose positron emission tomography, non-small cell lung cancer, maximum standardized uptake value, disease-free survival, overall survival

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