Prognostic value of metabolic parameters measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography in surgically resected non-small cell lung cancer patients

Boon Mathew; Nilendu C Purandare; Ameya Puranik; Sneha Shah; Archi Agrawal; C S Pramesh; George Karimundackal; Sabita Jiwnani; Venkatesh Rangarajan

doi:10.4103/wjnm.WJNM_26_19

Prognostic value of metabolic parameters measured by ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography in surgically resected non-small cell lung cancer patients

World J Nucl Med. 2020 Feb 27;19(1):8-14. doi: 10.4103/wjnm.WJNM_26_19. eCollection 2020 Jan-Mar.

Authors

Boon Mathew¹, Nilendu C Purandare¹, Ameya Puranik¹, Sneha Shah¹, Archi Agrawal¹, C S Pramesh², George Karimundackal², Sabita Jiwnani², Venkatesh Rangarajan¹

Affiliations

¹ Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
² Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.

Abstract

¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography-derived metabolic parameters can play a role in prognostication. We investigated the prognostic value of various metabolic parameters such as maximum standardized uptake value (SUV_max), mean SUV (SUV_mean), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG) in surgically resected non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed 153 patients with NSCLC who underwent surgical resection. The SUV_max, SUV_mean, WBMTV, and WBTLG of the tumor were measured. Continuous PET parameters were stratified by receiver operating characteristic curve analysis. Prognostic factors were estimated using the Kaplan-Meier method and Cox proportional hazards model. The median follow-up was 36.9 months. Fifty-six patients died and 78 patients had recurrence. On univariate analysis, tumor-node-metastasis (TNM) stage; male sex; no adjuvant treatment; and higher SUV_max, SUV_mean, WBMTV, and WBTLG were statistically significant and were associated with poor overall survival (OS). TNM stage; no adjuvant treatment; and higher SUV_max, SUV mean, WBMTV, and WBTLG were statistically significant and were associated with poor disease-free survival (DFS). On multivariate analysis, higher WBTLG (hazard ratio [HR] = 3.08, P = 0.007) for DFS and higher WBTLG (HR = 2.70, P = 0.041) and TNM staging (HR = 1.63, P = 0.035) for OS were statistically significant. Whole-body tumor burden assessment with TLG has independent prognostic value in patients with operated lung cancer. Incorporation of TLG into clinical practice can identify patients benefitted from additional therapy.

Keywords: 18F-fluorodeoxyglucose positron emission tomography-computed tomography; lung cancer; metabolic parameters; prognostic value; total lesion glycolysis.