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Kavurgaci S, Özmen Ö, Tatci E, Söyler Y, Cengiz Tİ, Kabalak PA, Kizilgöz D, Yilmaz Ü. Potential role of pre-treatment bone marrow SUVmean to liver SUVmean ratio (BM/L) and comparison of primary tumour FDG uptake with brain FDG uptake in predicting survival in limited-stage lung cancers. Nucl Med Commun 2024; 45:77-85. [PMID: 37779431 DOI: 10.1097/mnm.0000000000001778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
INTRODUCTION The survival rates of patients with limited-stage small-cell lung cancer are low despite curative treatment. Accordingly, we investigated the disease prognosis by comparing the pre-treatment bone marrow mean standardised uptake values (SUVmean) / liver SUVmean ratio (BM/L) and primary tumour FDG uptake and brain FDG uptake to prognosis. MATERIALS AND METHODS This was an observational, retrospective, single-centre study of patients with limited-stage small-cell lung cancer. Maximum standardised uptake values before treatment SUVmax, mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), liver (KC) SUVmean, bone marrow SUVmean, BM/L ratio (grouped as BM/L <1 and BM/L<1), FDG uptake level of the primary tumour are higher than brain FDG uptake. The association of low prevalence with overall survival (OS) and progression-free survival (PFS) was evaluated. DISCUSSION A total of 125 patients were included in the study. The risk of death was found to be two times higher in patients with primary tumour FDG uptake higher than brain FDG uptake compared to those with less brain involvement. The risk of death in patients with BM/L>1 was found to be 1.6 times higher than in patients with BM/L<1. CONCLUSION Comparison of BM/L, FDG uptake of the primary tumour and brain FDG uptake as new prognostic parameters can be guiding in the classification of patients with LD-SCLC with a higher risk of death or progression and in planning new treatment strategies.
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Affiliation(s)
- Suna Kavurgaci
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
| | - Özlem Özmen
- Ankara Etlik City Hospital, Nuclear Medicine Department, Ankara, Turkey
| | - Ebru Tatci
- Ankara Etlik City Hospital, Nuclear Medicine Department, Ankara, Turkey
| | - Yasemin Söyler
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
| | - Tuba İnal Cengiz
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
| | - Pinar Akin Kabalak
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
| | - Derya Kizilgöz
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
| | - Ülkü Yilmaz
- Ankara Atatürk Sanatorium Training and Research Hospital, Pulmonology Department and
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Guo J, Shen L, Ren Z, Liu Y, Liang C. Long-term results of postoperative unsuspected small cell lung cancer on real-world data. BMC Cancer 2022; 22:1256. [PMID: 36461029 PMCID: PMC9719118 DOI: 10.1186/s12885-022-10341-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In traditional opinion, solid pulmonary nodule suspected lung cancer should be confirmed by pathology before the operation to exclude small cell lung cancer (SCLC), considering SCLC tends to be aggressive and surgical effect in the management of SCLC remains controversial. The aim of this study was to evaluate the survival result and risk factors of postoperative unsuspected SCLC. METHODS A total of 120 patients with postoperative unsuspected SCLC who were confirmed by pathology and referred to Chinese PLA General Hospital between 2000 and 2021 were retrospectively analyzed (surgery group). Additionally, 120 patients with limited-stage SCLC who underwent chemotherapy and radiotherapy in the same period were enrolled in the chemoradiotherapy group.. Kaplan-Meier method was used to estimate survival; the Log-Rank test was used to compare survival rates between different groups; a COX stepwise regression model was used for multivariate analysis. RESULTS Among 120 patients in the surgery group, 28 were with central type and other 92 with peripheral type. The median survival (OS) was 44.85 months, and the 5-year survival rate was 46%. The 5-year survival rates for stage I, II, and III were 52.1%, 45.4%, and 27.8%, respectively. The mean disease-free survival time (DFS) was 30.63 ± 4.38 months, and the 5-year DFS rate was 31.5%. In the chemoradiotherapy group, the mean OS was 21.4 ± 4.26 months, and the 5-year survival rate was 28.3%. The 5-year survival rates for clinical stage I, II, and III were 42.5%, 39.8%, and 20.5%, respectively. The mean progression-free survival (PFS) was 10.63 ± 3.6 months. In the surgery group, one-way ANOVA revealed that the gender, symptoms, smoking history, tumor location, and postoperative radiotherapy were not associated with OS (P ≥ 0.05), while age, surgical approach, surgical method, N stage, TNM stage, and vascular tumor thrombus were related to OS (P < 0.05). Multivariate analysis indicated that the N stage was associated with OS (HR = 1.86 P = 0.042). CONCLUSION Surgery and adjuvant therapy were found to have encouraging outcomes in postoperative unsuspected SCLC. Patients with stage I, stage II and part of stage IIIA SCLC could benefit from surgery and the standard lobectomy, and systematic lymph node dissection, is also recommended for these patients.
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Affiliation(s)
- Juntang Guo
- grid.414252.40000 0004 1761 8894Department of Thoracic Surgery, The First Medical Center, The Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Leilei Shen
- grid.414252.40000 0004 1761 8894Department of Thoracic Surgery, The Hainan Hospital, The Chinese PLA General Hospital, Sanya, Hainan Province People’s Republic of China
| | - Zhipeng Ren
- grid.414252.40000 0004 1761 8894Department of Thoracic Surgery, The First Medical Center, The Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Yang Liu
- grid.414252.40000 0004 1761 8894Department of Thoracic Surgery, The First Medical Center, The Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Chaoyang Liang
- grid.414252.40000 0004 1761 8894Department of Thoracic Surgery, The First Medical Center, The Chinese PLA General Hospital, Beijing, People’s Republic of China
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Prognostic Value of 18F-FDG-PET Parameters in Patients with Small Cell Lung Cancer: A Meta-Analysis and Review of Current Literature. Diagnostics (Basel) 2021; 11:diagnostics11020174. [PMID: 33530446 PMCID: PMC7912276 DOI: 10.3390/diagnostics11020174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/18/2021] [Accepted: 01/22/2021] [Indexed: 01/29/2023] Open
Abstract
Many studies have suggested a prognostic value of one or several positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC). However, studies are often small, and there is a considerable interstudy disagreement about which PET parameters have a prognostic value. The objective of this study was to perform a review and meta-analysis to identify the most promising PET parameter for prognostication. PubMed®, Cochrane, and Embase® were searched for papers addressing the prognostic value of any PET parameter at any treatment phase with any endpoint in patients with SCLC. Pooled hazard ratios (HRs) were calculated by a random effects model for the prognostic value of the baseline maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV). The qualitative analysis included 38 studies, of these, 19 studies were included in the meta-analyses. The pooled results showed that high baseline MTV was prognostic for overall survival (OS) (HR: 2.83 (95% confidence interval [CI]: 2.00–4.01) and progression-free survival (PFS) (HR: 3.11 (95% CI: 1.99–4.90)). The prognostic value of SUVmax was less pronounced (OS: HR: 1.50 (95% CI: 1.17–1.91); PFS: HR: 1.24 (95% CI: 0.94–1.63)). Baseline MTV is a strong prognosticator for OS and PFS in patients with SCLC. MTV has a prognostic value superior to those of other PET parameters, but whether MTV is superior to other prognosticators of tumor burden needs further investigation.
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Özdemir Ö, Batum Ö, Ermin S, Aksel N, Kömürcüoğlu B, Mertoğlu A, Deniz S, Balcı G, Koparal H, Özbilek E, Yılmaz U. Metabolic activity of primary tumour on PET/CT has a relationship with survival in stages I-III small-cell lung carcinoma. THE CLINICAL RESPIRATORY JOURNAL 2020; 14:695-702. [PMID: 32170990 DOI: 10.1111/crj.13186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/15/2020] [Accepted: 03/09/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION There is limited evidence about the prognostic value of FDG-PET/CT metrics in small cell lung cancer (SCLC) patients staged with TNM staging system. OBJECTIVES The aim of this study is to examine the prognostic value of pretreatment FDG-SUVmax in patients with SCLC staged with 8th TNM staging system. METHODS A total of 344 (292 male) SCLC patients with pretreatment FDG- PET/CT were included. One hundred fifty-three of cases were stages I-III, 191 were stage IV. SUVmax values were obtained for primary tumour, lymph nodes and metastases. Univariate and multivariate analysis were performed to determine the effect of pretreatment SUVmax, with cut-off value of median, on progression-free and overall survival (PFS and OS). RESULTS Median OS and PFS for patients with stages I-III were 16.50 and 11.00 months, respectively. Median OS and PFS for patients with stage IV were 10.00 and 7.00 months, respectively. SUVmax of the primary tumour (PT), lymph nodes or metastasis were not associated with OS and PFS on univariate analysis. On multivariate analysis, SUVmax -PT with cut-off value of 11.60 was found to be an independent prognostic factor for OS in patients with stages I-III (HR;1.88, 95% CI:1.15-3.08, P = .012). But the SUVmax -PT (HR; 1.60, 95% CI: 0.99-2.60; P = .057) for PFS was found to be a prognostic factor with marginal significance. SUVmax were not significantly associated with OS and PFS in patients with stage IV disease. CONCLUSION Pretreatment SUVmax -PT (median cut-off 11.6) may have a prognostic value of OS and PFS in patients with TNM staged I-III SCLC.
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Affiliation(s)
- Özer Özdemir
- Department of Pulmonology, Kemalpaşa State Hospital, İzmir, Turkey
| | - Özgür Batum
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Sinem Ermin
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Nimet Aksel
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Berna Kömürcüoğlu
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Aydan Mertoğlu
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Sami Deniz
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Günseli Balcı
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Hakan Koparal
- Department of Nuclear Medicine, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Engin Özbilek
- Department of Nuclear Medicine, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Ufuk Yılmaz
- Department of Pulmonology, University of Health Sciences, Dr Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey
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Choi EK, Park M, Im JJ, Chung YA, Oh JK. Prognostic value of 18F-FDG PET/CT metabolic parameters in small cell lung cancer. J Int Med Res 2019; 48:300060519892419. [PMID: 31880209 PMCID: PMC7607737 DOI: 10.1177/0300060519892419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective To compare the prognostic values of metabolic parameters from pretreatment PET/CT between limited disease (LD) and extensive disease (ED) small cell lung cancer (SCLC) patients. Methods Data on 118 newly diagnosed SCLC patients (50 LD and 68 ED) who underwent pretreatment positron emission tomography–computed tomography (PET/CT) were reviewed. For PET, metabolic parameters were measured for: (1) primary tumor, maximum standardized uptake value (SUVmax), metabolic tumor volume, and total lesion glycolysis; and (2) all tumor lesions, SUVmax of the hottest tumor, whole body metabolic tumor volume (WBMTV), and whole body total lesion glycolysis (WBTLG). Prognostic values of metabolic parameters and other clinical variables were analyzed to predict overall survival (OS). Results In LD, SUVmax of the primary tumor was an independent prognostic factor for OS. Patients with high SUVmax showed significantly worse OS than those with low SUVmax. In ED, WBMTV and WBTLG were independent prognostic factors for OS. Patients with high WBMTV or WBTLG showed significantly worse OS than those with low WBMTV or WBTLG. Conclusions SUVmax of primary tumor was the only independent prognostic factor for OS in LD SCLC patients. WBMTV and WBTLG were independent prognostic factors in ED SCLC patients.
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Affiliation(s)
- Eun Kyoung Choi
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Minjae Park
- Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jooyeon Jamie Im
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Kyoung Oh
- Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Jin Kyoung Oh, Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon, 21431, Republic of Korea.
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Quartuccio N, Evangelista L, Alongi P, Caobelli F, Altini C, Cistaro A, Lambertini A, Schiorlin I, Popescu CE, Linguanti F, Laudicella R, Scalorbi F, Di Pierro G, Asabella AN, Cuppari L, Margotti S, Lima GM, Scalisi S, Pacella S, Kokomani A, Ciaccio A, Sturiale L, Vento A, Cardile D, Baldari S, Panareo S, Fanti S, Rubini G, Schillaci O, Chiaravalloti A. Prognostic and diagnostic value of [18F]FDG-PET/CT in restaging patients with small cell lung carcinoma: an Italian multicenter study. Nucl Med Commun 2019; 40:808-814. [PMID: 31136534 DOI: 10.1097/mnm.0000000000001038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Natale Quartuccio
- Nuclear Medicine Unit, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo
| | - Laura Evangelista
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - Pierpaolo Alongi
- Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Cefalù
| | - Federico Caobelli
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Angelina Cistaro
- Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin
| | - Alessandro Lambertini
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | | | | | - Flavia Linguanti
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Riccardo Laudicella
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Federica Scalorbi
- Nuclear Medicine Department, IRCCS Istituto Nazionale dei Tumori, Milano
| | | | | | - Lea Cuppari
- Nuclear Medicine Unit, Veneto Institute of Oncology IOV - IRCCS, Padua
| | - Simone Margotti
- Positron Emission Tomography Centre, IRMET S.p.A., Affidea, Turin
| | - Giacomo M Lima
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | - Salvatore Scalisi
- Department of Radiological Sciences, Nuclear Medicine Unit, Fondazione Istituto G. Giglio, Cefalù
| | - Sara Pacella
- Nuclear Medicine Department, Niguarda Ca' Granda Hospital
| | - Aurora Kokomani
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Alfonso Ciaccio
- Nuclear Medicine Unit, Department of Experimental and Clinical Biomedical Sciences 'Mario Serio'
| | - Letterio Sturiale
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Antonio Vento
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Davide Cardile
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, Messina
| | - Stefano Panareo
- Unit of Nuclear Medicine, Department of Diagnostic Imaging, S. Anna University Hospital, Ferrara
| | - Stefano Fanti
- Nuclear Medicine Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna
| | | | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome
- IRCCS Neuromed, Pozzilli (IS), Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University Tor Vergata, Rome
- IRCCS Neuromed, Pozzilli (IS), Italy
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Tu H, He Y, Huang T, Choe S, Lan X, Duan X, Sattar H, Li C, Zhou F. Predictive value of 18 F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma. Eur J Haematol 2017; 100:189-197. [PMID: 29226428 DOI: 10.1111/ejh.13006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate the association of 18 F-2'-deoxy 2'-fluorodeoxyglucose (18 F-FDG) PET/CT with clinical parameters in predicting patients with newly diagnosed multiple myeloma (MM). METHODS A total of 120 MM patients undergoing 18 F-FDG PET/CT scanning were analyzed in a retrospective cohort study. RESULTS Based on multivariate analysis, β2M, LDH, number of focal lesions (FLs), and SUVmax were significantly correlated with OS. These 4 variables were used to construct a new staging system (NSS) based on the number of risk factors. NSS provided a better discrimination of risk between stages III and II than International staging system (ISS) (P < .001 vs P = .086). For OS, there was no significant difference among risk groups in Durie-Salmon (DS) stage (P > .05). Based on Spearman correlation analysis, the presence of lesions in appendicular skeleton, number of FLs, and SUVmax appeared to indicate advanced stage of MM. ROC curves which showed the combination of β2M with calcium got a specificity of 96.3% for lesions in appendicular skeleton, and LDH alone had 100% specificity in predicting the number of FLs, although the sensitivity was only 50%. CONCLUSIONS 18 F-FDG PET/CT in combination with clinical parameters provided an accurate and simple method for risk stratification of patients with newly diagnosed MM.
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Affiliation(s)
- Honglei Tu
- Department of Clinical Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Yong He
- Department of Nuclear Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Tianhe Huang
- Department of Clinical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Songguk Choe
- Department of Nuclear Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoyi Duan
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haseeb Sattar
- Department of Clinical Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chongjiao Li
- Department of Nuclear Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Fuling Zhou
- Department of Clinical Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.,Hubei Key Laboratory of Tumor Biological Behavior, Wuhan, Hubei, China
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Kim H, Yoo IR, Boo SH, Park HL, O JH, Kim SH. Prognostic Value of Pre- and Post-Treatment FDG PET/CT Parameters in Small Cell Lung Cancer Patients. Nucl Med Mol Imaging 2017; 52:31-38. [PMID: 29391910 DOI: 10.1007/s13139-017-0490-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/21/2017] [Accepted: 07/25/2017] [Indexed: 02/04/2023] Open
Abstract
Purpose To evaluate the prognostic value of PET parameters obtained from pre- and post-treatment FDG PET/CT examinations in patients with SCLC. Methods Fifty-nine patients with initially diagnosed SCLC from 2009 to 2014 were included and had chemotherapy and/or concurrent chemoradiotherapy. FDG PET/CT examinations were performed before (PET1) and after (PET2) treatment to evaluate treatment response. A region of interest was placed over the primary lesion and metastatic lymph nodes within the thoracic cavity. PET parameters including change from PET1 to PET2 (Δ in %) were acquired: SUVmax, SUVpeak, MTV2.5, TLG, ΔSUVmax, ΔSUVpeak, ΔMTV and ΔTLG. Patient characteristics including staging, age, sex, LDH and response evaluation by RECIST were surveyed. Statistical analysis was done using Kaplan-Meier method and Cox regression analysis with respect to OS and PFS. Results The median follow-up was 9.6 months (2.5-80.5 months). 27 patients were LD and 32 were ED. Forty-six patients (78.0%) had died, and median OS was 8.6 months; 51 patients (86%) showed disease progression, and median PFS was 2.5 months. On univariate analysis, patients with ED, high interval change (ΔSUVmax and ΔSUVpeak) and low PET2 parameters showed longer OS and PFS. Multivariate analyses demonstrated that ΔSUVpeak (HR 2.6, P = 0.002) was an independent prognostic factors for OS, and MTV2.5 of PET2 (HR 2.8, P = 0.001), disease stage (HR 2.7, P = 0.003) and RECIST (HR 2.0, P = 0.023) were independent prognostic factors for PFS. Conclusions Metabolic and volumetric PET parameters obtained from pre- and post-treatment FDG PET/CT examinations in patients with SCLC have significant prognostic information.
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Affiliation(s)
- Hyoungwoo Kim
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Ie Ryung Yoo
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Sun Ha Boo
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Hye Lim Park
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Joo Hyun O
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
| | - Sung Hoon Kim
- Division of Nuclear Medicine, Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591 Republic of Korea
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Jin F, Qu B, Fu Z, Zhang Y, Han A, Kong L, Yu J. Prognostic Value of Metabolic Parameters of Metastatic Lymph Nodes on 18F-FDG PET/CT in Patients With Limited-stage Small-cell Lung Cancer With Lymph Node Involvement. Clin Lung Cancer 2017; 19:e101-e108. [PMID: 28690012 DOI: 10.1016/j.cllc.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/03/2017] [Accepted: 06/13/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We assessed the prognostic value of the metabolic parameters of different lesions, including primary tumors and metastatic lymph nodes (LNs), measured by fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/computed tomography in patients with limited-stage small-cell lung cancer (LS-SCLC) with LN metastasis. MATERIALS AND METHODS The present retrospective study included 46 patients with clinical stage II-III N1-N2 LS-SCLC who had undergone pretreatment fluorine-18 fluorodeoxyglucose PET/computed tomography scanning from January 2011 to December 2014. All patients underwent complete first-line therapy (concurrent chemoradiotherapy and prophylactic cranial irradiation). The metabolic parameters, including maximal standardized uptake value, mean standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) values of the PTs and metastatic LNs were measured on PET. Kaplan-Meier survival curves were used for evaluation of progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox proportional hazards models were used to analyze the prognostic factors. RESULTS The median OS and PFS were 25.9 months (range, 8.2-63.5 months) and 21 months (range, 6.4-55.3 months), respectively. Univariate analysis demonstrated that the Eastern Cooperative Oncology Group performance status, N1 station involvement, subcarinal LN metastasis, LN MTV, LN TLG, sum of the MTV, and summary of the TLG were significant predictive factors (P < .05). The Eastern Cooperative Oncology Group performance status, subcarinal nodal metastasis, LN MTV, and LN TLG were independent predictive factors of PFS and OS on multivariate analysis. CONCLUSION The metabolic parameters of metastatic LNs, other than lung lesions, are independent prognostic factors in patients with LS-SCLC with LN metastasis. These parameters could further stratify the prognosis of these patients, and these findings might provide functional imaging evidence for the future study of the mechanisms of metastasis.
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Affiliation(s)
- Feng Jin
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China; Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Bo Qu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zheng Fu
- PET/CT Center, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Yan Zhang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Anqin Han
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Li Kong
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China.
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