title: Whole-body metabolic tumour volume of 18F-FDG PET/CT improves the prediction of prognosis in small cell lung cancer.
abstract: OBJECTIVE
  We investigated whether the whole-body metabolic tumour volume (WBMTV) measured by (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can improve the prediction of prognosis in patients with small cell lung cancer (SCLC).
  
  
  METHODS
  We reviewed 106 consecutive patients (mean age 67 years, range 42-89 years, limited stage 45 patients, extensive stage 61 patients) with pathologically proven SCLC who underwent pretreatment FDG PET/CT. WBMTV and maximum standardized uptake value (SUV(max)) were measured in all malignant lesions. The Cox proportional hazards model was used with age, sex, performance status, lactate dehydrogenase (LDH), treatment, stage, SUV(max) and WBMTV to predict overall survival (OS) and progression-free survival (PFS). Subgroup analysis was performed using WBMTV combined with conventional staging and tumour node metastasis (TNM) staging.
  
  
  RESULTS
  The uni- and multivariate analyses showed that both stage and WBMTV were independent prognostic factors for death and progression. Patients with high WBMTV were associated with poor prognosis compared with patients with low WBMTV [hazard ratio = 2.11 (95% confidence interval 1.31-3.39) for death (p = 0.002) and 1.80 (95% confidence interval 1.16-2.80) for progression (p = 0.009)]. Incorporation of conventional staging and WBMTV could classify four subgroups with different prognoses (log-rank test, p < 0.001). Incorporation of TNM staging and WBMTV could classify six subgroups with different prognoses (log-rank test, p < 0.001).
  
  
  CONCLUSIONS
  WBMTV is an independent predictor for progression and death in patients with SCLC. Incorporation of WBMTV with TNM staging can provide a more detailed prediction of prognosis than WBMTV with conventional staging as well as tumour staging alone.
authors.affiliation: Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 42 Jebong-no, Donggu, Gwangju 501-757, Republic of Korea.
authors.forename: Jong-Ryool
authors.initials: JR
authors.lastname: Oh
authors.forename: Ji-Hyoung
authors.initials: JH
authors.lastname: Seo
authors.forename: Ari
authors.initials: A
authors.lastname: Chong
authors.forename: Jung-Joon
authors.initials: JJ
authors.lastname: Min
authors.forename: Ho-Chun
authors.initials: HC
authors.lastname: Song
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Kim
authors.forename: Hee-Seung
authors.initials: HS
authors.lastname: Bom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019788:Fluorodeoxyglucose F18