Nucl Med Mol Imaging.  2018 Feb;52(1):31-38. 10.1007/s13139-017-0490-9.

Prognostic Value of Pre- and Post-Treatment FDG PET/CT Parameters in Small Cell Lung Cancer Patients

• Kim H
• Yoo IR
• Boo SH
• Park HL
• O JH
• Kim SH

• KMID: 2407299
• DOI: http://doi.org/10.1007/s13139-017-0490-9

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. Fortysix 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.

Keyword

FDG PET/CT; Small-cell lung cancer; Prognosis; SUVpeak; Treatment response

MeSH Terms

Chemoradiotherapy
Disease Progression
Drug Therapy
Follow-Up Studies
Humans
Lymph Nodes
Methods
Multivariate Analysis
Positron-Emission Tomography and Computed Tomography*
Prognosis
Response Evaluation Criteria in Solid Tumors
Small Cell Lung Carcinoma*
Thoracic Cavity