Prognostic value of metabolic tumor volume and total lesion glycolysis from ¹⁸F-FDG PET/CT in patients undergoing stereotactic body radiation therapy for stage I non-small-cell lung cancer.
OBJECTIVE
The aim of this study was to evaluate the prognostic value of pretreatment F-fluorodeoxyglucose PET/computed tomography (CT), particularly in the assessment of metabolic tumor burden markers such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), with respect to clinical outcomes in stage I non-small-cell lung cancer (NSCLC) patients undergoing stereotactic body radiation therapy (SBRT).


METHODS
This retrospective study evaluated 50 patients who underwent SBRT for stage I NSCLC from May 2007 to December 2012. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), MTV, and TLG were measured from the PET/CT scan. The study population was dichotomized at the median into high and low groups. Kaplan-Meier log-rank tests were then used to compare high with low PET/CT parameter groups, and univariate Cox proportional hazards regression analysis was carried out to identify predictors of overall survival.


RESULTS
The 2-year local control rate was 93.7%. After a median follow-up of 25.1 months, the 2-year overall survival was 79.3%. Eight patients (16%) had disease recurrence. There were three local failures (6%), three mediastinal failures (6%), and six cases of distant metastases (12%). Both Kaplan-Meier actuarial analysis and Cox proportional hazards regression found no correlation between SUVmax, SUVavg, MTV, and TLG and overall survival.


CONCLUSIONS
Standard PET/CT measures, such as SUVmax, as well as newer measures of metabolic tumor burden, such as MTV and TLG, were not correlated with overall survival in our study population of stage I NSCLC patients undergoing SBRT. Larger studies with longer follow-up periods are needed to confirm these results.
Department of aRadiology bRadiation Oncology, Division of Cardiothoracic Surgery, Stony Brook University Medical Center, New York, USA.
Charles C
CC
Vu
Robert
R
Matthews
Bong
B
Kim
Dinko
D
Franceschi
Thomas V
TV
Bilfinger
William H
WH
Moore
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008297:Male; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
D019788:Fluorodeoxyglucose F18