title: The maximum standardized uptake value (SUVmax) on FDG-PET is a strong predictor of local recurrence for localized non-small-cell lung cancer after stereotactic body radiotherapy (SBRT).
abstract: BACKGROUND
  The maximum standardized uptake value (SUVmax) of FDG-PET may predict local recurrence for localized non-small-cell lung cancer (NSCLC) after stereotactic body radiotherapy (SBRT).
  
  
  METHODS
  Among 195 localized NSCLCs that were treated with total doses of either 40Gy or 50Gy in 5 SBRT fractions, we reviewed those patients who underwent pre-treatment FDG-PET using a single scanner for staging. Local control rates (LCRs) were obtained by the Kaplan-Meier method and a log-rank test. Prognostic significance was assessed by univariate and multivariate analyses.
  
  
  RESULTS
  A total of 95 patients with 97 lesions were eligible. Median follow-up was 16.0months (range: 6.0-46.3months). Local recurrences occurred in 9 lesions. By multivariate analysis, only the SUVmax of a primary tumor was a significant predictor (p=0.002). Two years LCRs for lower SUVmax (<6.0; n=78) and higher SUVmax (⩾6; n=19) were 93% and 42%, respectively. In subgroups with T1b and T2, LCRs were significantly better for lower SUVmax than for higher SUVmax (p<0.0005 and p<0.01). In both subgroups that received 40Gy and 50Gy, LCRs were also significantly better for lower SUVmax than for higher SUVmax (p<0.001 and p<0.01).
  
  
  CONCLUSIONS
  SUVmax was the strongest predictor for local recurrence. A high SUVmax may be considered for dose escalation to improve local control. Additional follow-up is needed to determine if SUVmax is correlated with regional recurrence, distant metastasis, and survival.
authors: Department of Radiology, Ofuna Chuo Hospital, Japan.
authors: Atsuya
authors: A
authors: Takeda
authors: Noriko
authors: N
authors: Yokosuka
authors: Toshio
authors: T
authors: Ohashi
authors: Etsuo
authors: E
authors: Kunieda
authors: Hirofumi
authors: H
authors: Fujii
authors: Yousuke
authors: Y
authors: Aoki
authors: Naoko
authors: N
authors: Sanuki
authors: Naoyoshi
authors: N
authors: Koike
authors: Yukihiko
authors: Y
authors: Ozawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18