Nucl Med Mol Imaging.  2017 Sep;51(3):233-239. 10.1007/s13139-016-0456-3.

Prognostic Value of Tumor-to-Blood Standardized Uptake Ratio in Patients with Resectable Non-Small-Cell Lung Cancer

• Shin S
• Pak K
• Kim IJ
• Kim BS
• Kim SJ

• KMID: 2396581
• DOI: http://doi.org/10.1007/s13139-016-0456-3

Abstract

OBJECTIVES
Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUV(max)). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery.
METHODS
Seventy-seven patients who underwent curative resection for NSCLC between January 2010 to December 2013 were enrolled in this study. ¹â¸Fluorine-fluorodeoxyglucose (¹â¸F-FDG) positron emission tomography/computed tomography (PET/CT) was performed before surgery. The mean standardized uptake value (SUV(mean)), SUV(max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of each lesion was measured, on the workstation. SUR(mean), SUR(max), and TLGSUR were calculated by dividing each of them by descending aorta SUV(mean). Cox proportional hazards regression was used to analyze the effect of age, sex, pathological parameters, and PET parameters on recurrence and death.
RESULTS
In Cox regression analysis, N stage predicted for both recurrence (p < 0.0001) and death (p < 0.0001). SUR(max) predicted recurrence (p = 0.0014), not death. Area under the receiver operating characteristic curve of SUR(max) was 0.759 with cutoff value 4.004. However, SUV(max), SUV(mean), MTV, TLG, SUR(mean), and TLGSUR predicted neither recurrence nor death.
CONCLUSIONS
Among PET parameters, SUR(max) was the independent predictor of recurrence in NSCLC patients who received curative surgery. N stage was the independent prognostic factor for both recurrence and death. Both parameters could be used to stratify the risk of NSCLC patients.

Keyword

Fluorodeoxyglucose F18; Positron-emission tomography; Prognosis; Non-small-cell lung cancer; Recurrence; Survival

MeSH Terms

Aorta, Thoracic
Electrons
Fluorodeoxyglucose F18
Glycolysis
Humans
Lung Neoplasms*
Lung*
Methods
Positron-Emission Tomography
Prognosis
Recurrence
ROC Curve
Tumor Burden
Fluorodeoxyglucose F18