Nucl Med Mol Imaging.  2018 Dec;52(6):453-461. 10.1007/s13139-018-0555-4.

Predictive Value of Preoperative Volume-Based 18F-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography/Computed Tomography Parameters in Patients with Resectable Lung Adenocarcinoma

• Choi S
• Kwon HR
• Cho HY
• Pahk K
• Lee SH
• Chung JH
• Kwon HW
• Kim S

• KMID: 2431983
• DOI: http://doi.org/10.1007/s13139-018-0555-4

Abstract

PURPOSE
This study aimed to investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), which are volume-based PET parameters, using 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (¹â¸F-FDG PET/CT) in patients with surgically resectable lung adenocarcinoma.
METHODS
We retrospectively evaluated 149 patients with lung adenocarcinoma who underwent 18F-FDG PET/CT before surgical resection. Maximum standardized uptake value (SUVmax), MTV, and TLG of the primary tumor with threshold value of SUVmax 30, 40, and 50% were calculated, respectively. To compare the predictive performance of volume-based PET parameters, recurrence-free survival was assessed using the Kaplan-Meier method.
RESULTS
The study included 70 males and 79 females with an average age of 65.8 years. The median follow-up time was 45.4 months. Recurrence was observed in 53 patients (35.6%). The mean ± SD SUVmax, MTV30%, and TLG(30%) of the entire cohort were 4.79 ± 2.94, 19.45 ± 24.85, and 56.43 ± 101.88, respectively. The cut-off values of MTV30% and TLG(30%) for recurrence were 11.07 ad 30.56, respectively. The 1-year recurrence-free survival (RFS) rate was 96.5% in low-MTV30% patients compared with 86.2% in high-MTV30% patients (p = 0.018) and 96.0% in low-TLG(30%) patients compared with 88.5% in high-TLG(30%) patients (p < 0.001). On univariate and multivariate analysis, TLG(30%) (HR, 2.828, p < 0.001; HR, 2.738, p < 0.001, respectively) was an independent prognostic factor for predicting recurrence-free survival (RFS).
CONCLUSION
TLG(30%) value was observed to be a significant prognostic factor for RFS in patients with lung adenocarcinoma treated by surgical resection.

Keyword

Lung adenocarcinoma; FDG PET/CT; Recurrence; Metabolic tumor volume; Total lesion glycolysis

MeSH Terms

Adenocarcinoma*
Cohort Studies
Electrons*
Female
Fluorodeoxyglucose F18
Follow-Up Studies
Glycolysis
Humans
Lung*
Male
Methods
Multivariate Analysis
Positron-Emission Tomography and Computed Tomography
Recurrence
Retrospective Studies
Tumor Burden
Fluorodeoxyglucose F18