Role of Various Metabolic Parameters Derived From Baseline 18F-FDG PET/CT as Prognostic Markers in Non–Small Cell Lung Cancer Patients Undergoing Platinum-Based Chemotherapy. (January 2018)

• Record Type: Journal Article
• Authors: Sharma, Akshima; Mohan, Anant; Bhalla, Ashu Seith; Sharma, Mehar Chand; Vishnubhatla, Sreenivas; Das, Chandan J.; Pandey, Anil Kumar; Sekhar Bal, Chandra; Patel, Chetan D.; Sharma, Punit; Agarwal, Krishan Kant; Kumar, Rakesh
• Is Part Of: Clinical nuclear medicine. Volume 43:Number 1(2018)
• Publication Date: 2018-01
• Subjects: 18F-FDG -- MTV -- non–small cell lung cancer -- PET/CT -- TLG; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000001886
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: The aim of this study was to prospectively evaluate the role of various quantitative and semiquantitative metabolic parameters derived from dynamic and static baseline 18 F-FDG PET/CT in prediction of overall survival (OS) in non–small cell lung cancer (NSCLC) patients who were planned to undergo platinum-based chemotherapy. Methods: Sixty patients (51 male and 9 female patients) with biopsy-proven NSCLC and mean age 59.55 ± 10.06 years who were planned to undergo platinum-based chemotherapy were enrolled in the study. Each patient underwent a baseline regional dynamic and a static whole-body 18 F-FDG PET/CT after injecting 0.21 mCi/kg (5.18–7.77 MBq/kg) of 18 F-FDG intravenously. Two dynamic PET/CT parameters, that is, net influx rate constant and glucose metabolic rate at 30 and 60 minutes, were evaluated. In addition, whole-body PET/CT parameters, that is, SUVmax, average SUV, tumor-to-background ratio, metabolic tumor volume (MTV), total lesion glycolysis (TLG) of the primary tumor, and MTV and TLG of whole-body tumor lesions, were evaluated. Best possible cutoffs for all parameters were calculated using receiver operating characteristic curve analysis. Survival analysis was performed using log-rank test, Kaplan-Meier curves, and Cox proportional hazards model to determine the prognostic markers for OS. Results: The median follow-up period was 4.4 months (range, 8 days to 15.9 months). In univariate analysis, the 4 static whole-body PET/CT parameters, that is, MTV, TLG, and MTV and TLG of whole-body tumor lesions, were found to be significantly associated with OS with cutoff values of 120, 800, 160, and 1350 cm 3 and hazard ratios of 3.64 ( P = 0.001), 3.35 ( P = 0.002), 2.51 ( P = 0.019), and 2.69 ( P = 0.008), respectively. In multivariate survival analysis, MTV was found to be an independent prognostic marker for OS. Conclusions: Baseline MTV and TLG evaluated from primary tumor as well as the whole-body tumor lesions are reliable prognostic markers of OS in NSCLC patients undergoing platinum-based chemotherapy. However, other baseline whole-body PET/CT parameters (SUVmax, average SUV, and tumor-to-background ratio) and dynamic PET/CT parameters (net influx rate constant, glucose metabolic rate) have no prognostic value in these patients.