Prognostic value of different metabolic measurements with fluorine-18 fluorodeoxyglucose positron emission tomography in resectable non-small cell lung cancer: a two-center study.
BACKGROUND
Standard uptake value (SUV) is a quantitative measure for the preferential uptake of a radiopharmaceutical in a tumor compared with the homogeneous distribution in the body. SUV can be based on the maximal value of one pixel (SUVmax) or on the mean value in a region outlined by isodensity contours. The prognostic value of different SUVs in non-small cell lung cancer (NSCLC) is not established. We evaluated this value for SUVmax, SUV70%, and SUV50% among patients with resectable NSCLC.


METHODS
All consecutive patients with resectable NSCLC who underwent an attenuation-corrected whole-body fluorine-18 fluorodeoxyglucose positron emission tomography scan from two university hospitals were selected. By adjusting the isocontour in the region of interest on the scan, SUVmax, SUV70%, and SUV50% of the primary tumor were calculated.


RESULTS
Sixty-six patients (50 male, median age 63 years) were included. Of the tumors, 16 were pathological stage IA, 23 were IB, 4 were IIA, 14 were IIB, and 9 were IIIA. Median (range) values for SUVmax, SUV70%, and SUV50% were 6.4 (1.6-19.1), 5.1 (1.0-15.7), and 4.0 (0.9-13.4), respectively. SUVs were associated with survival. Analysis of residuals of SUVmax as a continuous variable in a Cox's proportional hazard model for survival suggested no cutoff point and no indication of time-dependency. Patients with a SUV higher than the median value had a worse survival than patients with a SUV lower than median (hazard ratios for SUVmax, SUV70%, and SUV50% all were 2.9; p = 0.02).


CONCLUSIONS
SUVmax, SUV70%, and SUV50% measured with fluorine-18 fluorodeoxyglucose positron emission tomography have a similar prognostic value, and no "natural" cutoff point for SUVmax in resectable NSCLC was identified.
de Jong
Wouter K
WK
Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. w.k.de.jong@int.umcg.nl
van der Heijden
Henricus F M
HF
Pruim
Jan
J
Dalesio
Otilia
O
Oyen
Wim J G
WJ
Groen
Harry J M
HJ
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000378:metabolism; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism*; D015996:Survival Rate
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18