Prognostic Value of Semiautomatic CT Volumetry in Patients With Stage I Non-Small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy

J Comput Assist Tomogr. May-Jun 2016;40(3):343-50. doi: 10.1097/RCT.0000000000000368.


Objective: The aim of this study was to examine the prognostic value of semiautomated 3-dimensional image analysis-based parameters from pretreatment computed tomography (CT) in patients with non-small cell lung cancer treated with stereotactic body radiation therapy.

Methods: We evaluated 91 patients. We defined 2 parameters: (1) VOL, extracted tumor volume with a threshold ≥ -400 HU; and (2) ATN, the mean CT attenuation value. The maximum standardized uptake value (SUVmax) was recorded as F-fluorodeoxyglucose positron emission tomography/CT parameter. The prognostic values were assessed using the Kaplan-Meier and a Cox proportional hazards analysis.

Results: Overall survival and progression-free survival were significantly worse in patients with larger VOL, higher ATN, and higher SUVmax. VOL was an independent indicator of overall survival, whereas ATN was an indicator of progression-free survival, lymph node recurrence, and distant metastasis. However, SUVmax was not an independent prognostic factor for either outcome.

Conclusions: VOL and ATN from 3-dimensional image analysis of CT scans have prognostic values for non-small cell lung cancer patients treated with stereotactic body radiation therapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Disease-Free Survival
  • Female
  • Humans
  • Imaging, Three-Dimensional / statistics & numerical data
  • Japan / epidemiology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Staging
  • Prevalence
  • Prognosis
  • Radiosurgery / mortality*
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / statistics & numerical data*
  • Treatment Outcome
  • Tumor Burden