title: Feasibility study of FDG PET/CT-derived primary tumour glycolysis as a prognostic indicator of survival in patients with non-small-cell lung cancer.
abstract: OBJECTIVE
  To assess the feasibility and prognostic value of measuring total lesion glycolysis of the primary tumour (TLG(primary)) using combined 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) in patients with proven or suspected non-small-cell lung cancer (NSCLC) in the routine diagnostic setting.
  
  
  METHODS
  At the All wales Research and Diagnostic Positron Emission Tomography Centre in Cardiff (PETIC), in the calendar year 2011, 288 consecutive patients were identified with a single pulmonary mass in whom NSCLC was confirmed or clinically diagnosed following multidisciplinary team review. In a retrospective analysis, for each patient the PET-derived volume of the primary tumour and SUVMEAN was calculated using adaptive thresholds of 40% and 50% of the SUVMAX of the primary tumour. The TLG(primary) (calculated by volume x SUVMEAN) was calculated at these two thresholds and was used to predict survival in a multivariate analysis with TNM (tumour, node, metastasis) stage, age, sex, and SUV(MAX). The primary endpoint was overall survival over a minimum follow-up of at least 7 months.
  
  
  RESULTS
  In virtually every case, the primary tumour could be measured using the automated software with minimal use of manual adjustments. In multivariate analysis, TNM clinical stage, log(TLG(primary)) and sex were independent predictors of overall survival.
  
  
  CONCLUSIONS
  Measurements of primary tumour total lesion glycolysis are simple to perform and provide additional prognostic information over and above that provided by TNM staging.
authors: All Wales Research and Diagnostic Positron Emission Tomography Centre in Cardiff (PETIC), Department of Radiology, University Hospital of Wales, Heath Park, Cardiff, UK.
authors: G
authors: G
authors: Mehta
authors: All Wales Research and Diagnostic Positron Emission Tomography Centre in Cardiff (PETIC), Department of Radiology, University Hospital of Wales, Heath Park, Cardiff, UK.
authors: A
authors: A
authors: Chander
authors: South East Wales Trials Unit/Research Design and Conduct Service, Cardiff University School of Medicine, Heath Park, Cardiff, UK.
authors: C
authors: C
authors: Huang
authors: South East Wales Trials Unit/Research Design and Conduct Service, Cardiff University School of Medicine, Heath Park, Cardiff, UK.
authors: M
authors: M
authors: Kelly
authors: All Wales Research and Diagnostic Positron Emission Tomography Centre in Cardiff (PETIC), Department of Radiology, University Hospital of Wales, Heath Park, Cardiff, UK. Electronic address: Patrick.fielding@wales.nhs.uk.
authors: P
authors: P
authors: Fielding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011857:Radiographic Image Interpretation, Computer-Assisted; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18