Whole Body Metabolic Tumor Volume and Total Lesion Glycolysis Predict Survival in Patients with Adrenocortical Carcinoma.
BACKGROUND
Adrenocortical carcinoma (ACC) is a rare but lethal malignancy with few reliable prognostic markers. FDG-PET metabolic parameters have been shown to predict survival in several cancers. The objective was to determine if metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) could serve as prognostic markers in patients with ACC.


METHODS
A total of 30 patients with ACC prospectively underwent 18F-FDG PET/CT prior to treatment. Whole body MTV, TLG, and SUVmax were measured by a semiautomatic method. A median cutoff was used to determine an association with overall survival (OS) from the time of 18F-FDG PET/CT by the Kaplan-Meier method.


RESULTS
Patients with high whole body MTV (>87.0 mL),TLG (>229.4 SUVlbm*mL), or SUVmax (>8.9 SUV) had a worse OS compared with those with low whole body MTV (median OS, 24 vs 45.1 months, p < .01), TLG (median OS, 24 vs 40.3 months, p < .005), or SUVmax (median OS, 23.7 vs 35.5 months, p < .02). In patients who had operable disease (n = 23), high whole body MTV (>87.0 mL) and TLG (>229.4 SUVlbm*mL) had a worse OS compared with those with low whole body MTV (median OS, 25.1 vs 45.1 months, p < .05) and TLG (median OS, 25.1 vs 40.3 months, p < .05), but a high SUVmax (>8.9 SUV) was not associated with worse OS (p = .11).


CONCLUSIONS
Patients with ACC and a high whole body MTV, TLG, and SUVmax have a worse prognosis and OS. Measurement of whole body MTV and TLG may be helpful for guiding therapy for patients with ACC.
Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA.|Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Kei
K
Satoh
Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA. divot999@gmail.com.
Dhaval
D
Patel
PET Department, Clinical Center, NIH, Bethesda, MD, USA.
William
W
Dieckmann
Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Naris
N
Nilubol
Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Electron
E
Kebebew
D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000378:metabolism / Q000401:mortality / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006019:Glycolysis; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008175:Lung Neoplasms / Q000378:metabolism / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D015996:Survival Rate; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18