title: Value of dual time point F-18 FDG-PET/CT imaging for the evaluation of prognosis and risk factors for recurrence in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy.
abstract: OBJECTIVE
  To investigate prognostic and risk factors for recurrence after stereotactic body radiation therapy (SBRT) in patients with stage I non-small cell lung carcinoma (NSCLC), focusing on dual time point [18]F-fluorodeoxyglucose positron emission tomography (FDG PET).
  
  
  METHODS
  We prospectively evaluated 57 patients with stage I NSCLC (45 T1N0M0 and 12 T2N0M0) who had undergone pretreatment FDG-PET/CT and were subsequently treated with SBRT. All patients received a whole-body PET/CT scan at 60 min and a whole-lung at 120 min after the injection. The maximum standardized uptake value (SUV) and retention index (RI) of the lesions were calculated. Local recurrence, regional lymph node metastasis, distant metastasis, and the recurrence pattern were evaluated. Cox proportional hazard regression analyses were performed to evaluate prognostic factors or risk factors of recurrence.
  
  
  RESULTS
  During the median follow-up period of 27 months, local recurrence, regional lymph node metastasis, and distant metastasis were seen in 17 (30%), 12 (21%), and 17 (30%) of the 57 patients, respectively. The 3-year overall survival rate was 63.4%. SUVmax did not affect any recurrence, DFS, OS, or CSS. RI significantly predicted higher distant metastasis (HR 47.546, p=0.026). In contrast, RI tended to predict lower local recurrence (HR 0.175, p=0.246) and regional lymph node metastasis (HR 0.109, p=0.115).
  
  
  CONCLUSIONS
  SUVmax at staging FDG-PET does not predict any recurrence, DFS, OS or CSS. In contrast, higher RI predicts higher distant metastasis and tended to predict lower local or regional lymph node metastasis.
authors.affiliation: PET Center, Kofu Neurosurgical Hospital, ZIP Code 400-0805, Sakaori 1-16-18, Kofu city, Yamanashi Prefecture, Japan. pecampecam@yahoo.co.jp
authors.forename: Yoko
authors.initials: Y
authors.lastname: Satoh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nambu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sawada
authors.forename: Licht
authors.initials: L
authors.lastname: Tominaga
authors.forename: Kengo
authors.initials: K
authors.lastname: Kuriyama
authors.forename: Takafumi
authors.initials: T
authors.lastname: Komiyama
authors.forename: Kan
authors.initials: K
authors.lastname: Marino
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aoki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Araya
authors.forename: Ryo
authors.initials: R
authors.lastname: Saito
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Maehata
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Oguri
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016634:Radiosurgery; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18