Volumetric PET parameters can predict overall survival in advanced lung adenocarcinoma

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2020 Jan-Feb;39(1):3-8. doi: 10.1016/j.remn.2019.09.004. Epub 2019 Dec 6.
[Article in English, Spanish]

Abstract

Objective: The present study evaluates the prognostic value of metabolic parameters related to the primary tumor on pretreatment 18F FDG PET/CT in patients with advanced stage lung adenocarcinoma.

Material and methods: This retrospective study included 258 patients with advanced stage lung adenocarcinoma who underwent pretreatment PET/CT scan, and for whom epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) status was available. The maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) related to the primary tumor at the baseline PET and various clinical factors were recorded. The relation between these factors and overall survival (OS) and progression-free survival (PFS) was evaluated.

Results: The study included 258 patients with stage IIIB-IV lung adenocarcinoma (72 female, 186 male, mean age 60.4±10.4 years), 210 of which died and 243 of which progressed at the time of analysis. The median OS and PFS of the patients were 16±1.9 and 5±0.5 months, respectively. The present study revealed no significant relation between OS or PFS and gender, smoking status, presence of distant metastasis, age and tumor size. There was no significant difference in the OS and PFS of patients testing negative for EGFR mutations/ALK rearrangements and those testing positive for both or either of the EGFR mutations and ALK rearrangements. OS was significantly longer in patients with low MTV(p=0.011) and those with low TLG(p=0.012) than high ones. However, no significant relation was found between SUVmax and SUVmean values and OS, and between all PET parameters and PFS.

Conclusion: MTV and TLG reflecting the metabolic tumor burden can predict OS in patients with advanced lung adenocarcinoma.

Keywords: Cáncer pulmonar de células no pequeñas; FDG PET/CT; FDG PET/TC; MTV; Nonsmall cell lung cancer; Prognosis; Pronóstico; SUVmax; SUVmáx; Supervivencia; Survival; TLG.

MeSH terms

  • Adenocarcinoma of Lung / diagnostic imaging*
  • Adenocarcinoma of Lung / metabolism
  • Adenocarcinoma of Lung / mortality*
  • Adenocarcinoma of Lung / pathology
  • Adult
  • Aged
  • Aged, 80 and over
  • Anaplastic Lymphoma Kinase / genetics
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Disease Progression
  • ErbB Receptors / genetics
  • Female
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Genes, erbB
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Mutation
  • Positron Emission Tomography Computed Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals* / pharmacokinetics
  • Retrospective Studies
  • Sex Factors
  • Tumor Burden

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • ErbB Receptors