Standard uptake value predicts survival in non-small cell lung cancer.
BACKGROUND
Integrated [(18)F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scan is a widely used modality in the evaluation of lung cancer. Our goal was to determine the ability of the standard uptake value (SUV) of the primary tumor (SUV-T) and regional lymph nodes (SUV-N) to predict survival.


METHODS
From January 2005 through June 2007, 584 consecutive patients undergoing integrated PET-CT scan for suspected lung cancer were studied. Results of integrated PET-CT scans, including the maximum SUV-T and SUV-N, were recorded. A patient was defined as having a positive PET scan if the maximum SUV (T or N) was greater than 2.5. Overall survival was documented from clinical records and the Social Security Death Index. Cox regression analysis was used to evaluate the correlation between SUV and survival.


RESULTS
Among patients with a positive PET scan (n = 329), both SUV-T and SUV-N were predictors of survival. As maximum SUV of the primary mass increased, survival decreased (hazard ratio, 1.05; p < 0.001). As maximum SUV of locoregional lymph nodes increased, survival also decreased (hazard ratio, 1.06; p < 0.001). Furthermore, among patients with no mediastinal disease identified by PET-CT scan, increased SUV-T continued to predict poor survival (hazard ratio, 1.06; p = 0.001).


CONCLUSIONS
Local and regional maximum SUVs defined by integrated PET-CT scanning have a strong correlation with survival in patients with non-small cell lung cancer. An elevated SUV is known preoperatively and may assist clinicians in stratifying patients at increased overall risk preoperatively.
Okereke
Ikenna C
IC
Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Gangadharan
Sidhu P
SP
Kent
Michael S
MS
Nicotera
Saila P
SP
Shen
Changyu
C
DeCamp
Malcolm M
MM
D000368:Aged; D000465:Algorithms; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008481:Mediastinoscopy; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18