Prognostic value of volumetric metabolic parameters measured by [18F]fluorodeoxyglucose-positron emission tomography/computed tomography in patients with small cell lung cancer

Cancer Imaging. 2014 Apr 22;14(1):2. doi: 10.1186/1470-7330-14-2.


Background: We evaluated the prognostic value of volume-based metabolic positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC) compared with other factors.

Methods: The subjects were 202 patients with pathologically proven SCLC who underwent pretreatment 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT). Volumetric metabolic parameters of intrathoracic malignant hypermetabolic lesions, including maximum and average standardized uptake value, sum of metabolic tumor volume (MTV), and sum of total lesion glycolysis (TLG) were measured.

Results: 164 patients had died during follow-up (median 17.4 months) and median overall survival was 14 months. On univariate survival analysis, age, stage, treatment modality, sum of MTV (cutoff = 100 cm3), and sum of TLG (cutoff = 555) were significant predictors of survival. There was a very high correlation between the sum of MTV and the sum of TLG (r = 0.963, P < 0.001). On multivariate survival analysis, age (HR = 1.04, P < 0.001), stage (HR = 2.442, P < 0.001), and sum of MTV (HR = 1.662, P = 0.002) were independent prognostic factors. On subgroup analysis based on limited disease (LD) and extensive disease (ED), sum of MTV and sum of TLG were significant prognostic factors only in LD.

Conclusion: Both sum of MTV and sum of TLG of intrathoracic malignant hypermetabolic lesions are important independent prognostic factors for survival in patients with SCLC, in addition to age and clinical stage. However, it may be more useful in limited disease rather than in extensive disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals*
  • Retrospective Studies
  • Small Cell Lung Carcinoma / diagnostic imaging
  • Small Cell Lung Carcinoma / metabolism
  • Small Cell Lung Carcinoma / mortality*
  • Tomography, X-Ray Computed / methods*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18