title: Prognostic value of SUVmax and metabolic tumor volume on 18F-FDG PET/CT in early stage non-small cell lung cancer patients without LN metastasis.
abstract: This paper aimed to evaluate the prognostic value of maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of the primary tumor on (18)F-FDG PET/CT scan in early stage non-small cell cancer (NSCLC) patients without lymph node (LN) metastasis. In the experiment, eighty NSCLC patients pathologically staged as T1N0 or T2N0 were included (M:F=50:30; mean age, 64.8 years). All patients had preoperative (18)F-FDG PET/CT scan and curative surgery. FDG uptake in the primary tumor was measured by SUVmax and MTV with various SUV threshold values. SUVmax, MTV of the primary tumor, age, tumor size, histology and differentiation grade were analyzed for association with disease-free survival (DFS). The experimental results showed that the histology types included adenocarcinoma (n=58), squamous cell carcinoma (n=20), and others (n=2); Twenty-two (27.5%) of the 80 patients had a recurrence during follow-up at a median time of 29.1 months; The median SUVmax was 5.26, and the median MTV2.5 was 2.2 cm(3). Univariate analysis showed higher SUVmax (>4), greater MTV (MTV2.5 >4 cm(3)), and non-squamous histology were significantly associated with shorter period DFS (p=0.001, p=0.030 and p<0.001). In multivariate analysis, higher SUVmax (p=0.004) and adenocarcinoma histology (p=0.005) were associated with shorter DFS. Therefore, high SUVmax (>4) of the primary tumor on preoperative (18)F-FDG PET/CT scan is an independent prognostic factor of shorter DFS in early stage of NSCLC.
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ie Ryung
authors.initials: IeR
authors.lastname: Yoo
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Soo Kyo
authors.initials: SK
authors.lastname: Chung
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hye Lim
authors.initials: HL
authors.lastname: Park
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Woo Hee
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Kyoon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young-Pil
authors.initials: YP
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Non-small-cell lung cancer; PET/CT; early stage; metabolic tumor volume; standardized uptake value