The increment in standardized uptake value determined using dual-phase 18F-FDG PET is a promising prognostic factor in non-small-cell lung cancer

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Abstract

Purpose: We aimed to determine whether the increment in the maximal standardized uptake value (SUVmax) of the primary lung tumour between the initial and delayed imaging by dual-phase 18F-FDG PET has prognostic value in patients with non-small-cell lung cancer (NSCLC). Methods: We reviewed the records of patients with NSCLC who underwent pretreatment dual-phase 18F-FDG PET/CT scans acquired at 1 h and 2 h after injection. The SUVmax increment (SUVinc) of the primary lung tumour was the 2-h SUVmax minus the 1-h SUVmax. Univariate and multivariate analyses were used to assess the prognostic significance of SUVinc, retention index, whole-body total metabolic tumour volume, whole-body total lesion glycolysis (TLGwb), 1-h SUVmax, 2-h SUVmax, gender, age, performance status, histological subtype, T stage, N stage and clinical stage. Results: The records of 187 consecutive patients were reviewed. The median follow-up time was 3.9 years. The estimated median progression-free survival (PFS) and overall survival (OS) were 1.3 years and 4.4 years, respectively. An SUVinc cut-off value of >1 had the best discriminative yield for PFS. The 3-year PFS and OS were 61.6 % and 87.8 % in patients with SUVinc ≤1 versus 21.1 % and 46.2 % in patients with SUVinc >1 (all P<0.01). Using the forward stepwise multivariate Cox proportional hazards model, SUVinc, TLGwb, and clinical stage were significant factors for PFS (all P<0.01). A subgroup analysis of 117 patients treated with surgery showed that SUVinc (P=0.02) and clinical stage (P<0.01) were significant prognostic factors for PFS. Furthermore, in stage I patients treated with surgery alone, SUVinc was the only significant prognostic factor (HR 28.07; 95 % CI 2.42 - 326.41). Conclusion: SUVinc determined from dual-phase 18F-FDG PET is a promising prognostic factor for NSCLC. It adds to the value of dual-phase 18F-FDG PET.

Original languageEnglish
Pages (from-to)1478-1485
Number of pages8
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume40
Issue number10
DOIs
Publication statusPublished - 2013 Oct 1

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Fluorodeoxyglucose F18
Non-Small Cell Lung Carcinoma
Disease-Free Survival
Lung
Survival
Glycolysis
Tumor Burden
Proportional Hazards Models
Neoplasms
Multivariate Analysis
Injections

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{ebd170808065426992c27d373d72fd07,
title = "The increment in standardized uptake value determined using dual-phase 18F-FDG PET is a promising prognostic factor in non-small-cell lung cancer",
abstract = "Purpose: We aimed to determine whether the increment in the maximal standardized uptake value (SUVmax) of the primary lung tumour between the initial and delayed imaging by dual-phase 18F-FDG PET has prognostic value in patients with non-small-cell lung cancer (NSCLC). Methods: We reviewed the records of patients with NSCLC who underwent pretreatment dual-phase 18F-FDG PET/CT scans acquired at 1 h and 2 h after injection. The SUVmax increment (SUVinc) of the primary lung tumour was the 2-h SUVmax minus the 1-h SUVmax. Univariate and multivariate analyses were used to assess the prognostic significance of SUVinc, retention index, whole-body total metabolic tumour volume, whole-body total lesion glycolysis (TLGwb), 1-h SUVmax, 2-h SUVmax, gender, age, performance status, histological subtype, T stage, N stage and clinical stage. Results: The records of 187 consecutive patients were reviewed. The median follow-up time was 3.9 years. The estimated median progression-free survival (PFS) and overall survival (OS) were 1.3 years and 4.4 years, respectively. An SUVinc cut-off value of >1 had the best discriminative yield for PFS. The 3-year PFS and OS were 61.6 {\%} and 87.8 {\%} in patients with SUVinc ≤1 versus 21.1 {\%} and 46.2 {\%} in patients with SUVinc >1 (all P<0.01). Using the forward stepwise multivariate Cox proportional hazards model, SUVinc, TLGwb, and clinical stage were significant factors for PFS (all P<0.01). A subgroup analysis of 117 patients treated with surgery showed that SUVinc (P=0.02) and clinical stage (P<0.01) were significant prognostic factors for PFS. Furthermore, in stage I patients treated with surgery alone, SUVinc was the only significant prognostic factor (HR 28.07; 95 {\%} CI 2.42 - 326.41). Conclusion: SUVinc determined from dual-phase 18F-FDG PET is a promising prognostic factor for NSCLC. It adds to the value of dual-phase 18F-FDG PET.",
author = "Chen, {Helen H.W} and Bi-Fang Lee and Wu-Chou Su and Yu-Hsuan Lai and Chen, {Hung Yu} and How-Ran Guo and Wei-Jen Yao and Nan-Tsing Chiu",
year = "2013",
month = "10",
day = "1",
doi = "10.1007/s00259-013-2452-5",
language = "English",
volume = "40",
pages = "1478--1485",
journal = "European Journal of Nuclear Medicine and Molecular Imaging",
issn = "1619-7070",
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TY - JOUR

T1 - The increment in standardized uptake value determined using dual-phase 18F-FDG PET is a promising prognostic factor in non-small-cell lung cancer

AU - Chen, Helen H.W

AU - Lee, Bi-Fang

AU - Su, Wu-Chou

AU - Lai, Yu-Hsuan

AU - Chen, Hung Yu

AU - Guo, How-Ran

AU - Yao, Wei-Jen

AU - Chiu, Nan-Tsing

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Purpose: We aimed to determine whether the increment in the maximal standardized uptake value (SUVmax) of the primary lung tumour between the initial and delayed imaging by dual-phase 18F-FDG PET has prognostic value in patients with non-small-cell lung cancer (NSCLC). Methods: We reviewed the records of patients with NSCLC who underwent pretreatment dual-phase 18F-FDG PET/CT scans acquired at 1 h and 2 h after injection. The SUVmax increment (SUVinc) of the primary lung tumour was the 2-h SUVmax minus the 1-h SUVmax. Univariate and multivariate analyses were used to assess the prognostic significance of SUVinc, retention index, whole-body total metabolic tumour volume, whole-body total lesion glycolysis (TLGwb), 1-h SUVmax, 2-h SUVmax, gender, age, performance status, histological subtype, T stage, N stage and clinical stage. Results: The records of 187 consecutive patients were reviewed. The median follow-up time was 3.9 years. The estimated median progression-free survival (PFS) and overall survival (OS) were 1.3 years and 4.4 years, respectively. An SUVinc cut-off value of >1 had the best discriminative yield for PFS. The 3-year PFS and OS were 61.6 % and 87.8 % in patients with SUVinc ≤1 versus 21.1 % and 46.2 % in patients with SUVinc >1 (all P<0.01). Using the forward stepwise multivariate Cox proportional hazards model, SUVinc, TLGwb, and clinical stage were significant factors for PFS (all P<0.01). A subgroup analysis of 117 patients treated with surgery showed that SUVinc (P=0.02) and clinical stage (P<0.01) were significant prognostic factors for PFS. Furthermore, in stage I patients treated with surgery alone, SUVinc was the only significant prognostic factor (HR 28.07; 95 % CI 2.42 - 326.41). Conclusion: SUVinc determined from dual-phase 18F-FDG PET is a promising prognostic factor for NSCLC. It adds to the value of dual-phase 18F-FDG PET.

AB - Purpose: We aimed to determine whether the increment in the maximal standardized uptake value (SUVmax) of the primary lung tumour between the initial and delayed imaging by dual-phase 18F-FDG PET has prognostic value in patients with non-small-cell lung cancer (NSCLC). Methods: We reviewed the records of patients with NSCLC who underwent pretreatment dual-phase 18F-FDG PET/CT scans acquired at 1 h and 2 h after injection. The SUVmax increment (SUVinc) of the primary lung tumour was the 2-h SUVmax minus the 1-h SUVmax. Univariate and multivariate analyses were used to assess the prognostic significance of SUVinc, retention index, whole-body total metabolic tumour volume, whole-body total lesion glycolysis (TLGwb), 1-h SUVmax, 2-h SUVmax, gender, age, performance status, histological subtype, T stage, N stage and clinical stage. Results: The records of 187 consecutive patients were reviewed. The median follow-up time was 3.9 years. The estimated median progression-free survival (PFS) and overall survival (OS) were 1.3 years and 4.4 years, respectively. An SUVinc cut-off value of >1 had the best discriminative yield for PFS. The 3-year PFS and OS were 61.6 % and 87.8 % in patients with SUVinc ≤1 versus 21.1 % and 46.2 % in patients with SUVinc >1 (all P<0.01). Using the forward stepwise multivariate Cox proportional hazards model, SUVinc, TLGwb, and clinical stage were significant factors for PFS (all P<0.01). A subgroup analysis of 117 patients treated with surgery showed that SUVinc (P=0.02) and clinical stage (P<0.01) were significant prognostic factors for PFS. Furthermore, in stage I patients treated with surgery alone, SUVinc was the only significant prognostic factor (HR 28.07; 95 % CI 2.42 - 326.41). Conclusion: SUVinc determined from dual-phase 18F-FDG PET is a promising prognostic factor for NSCLC. It adds to the value of dual-phase 18F-FDG PET.

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