title: The Role of 18F-FDG PET/CT on Staging and Prognosis in Patients with Small Cell Lung Cancer.
abstract: BACKGROUND
  We evaluated 18F-FDG PET/CT in small cell lung cancer (SCLC) staging and assessed metabolic (SUVmax, MTV and TLG) and morphologic (CTvol) variables as predictors for overall survival (OS) and progression-free survival (PFS).
  
  
  METHODS
  Patients with newly diagnosed, histopathology-confirmed SCLC, who underwent 18F-FDG PET/CT were evaluated. A Cox proportional hazard model was used to determine the association between the primary tumour SUVmax, MTV, TLG and CTvol with OS and PFS. Similar evaluations were performed when hilar/mediastinal lymphadenopathy was included [total SUVmax (TSUVmax), total MTV (TMTV) and total TLG (TTLG)].
  
  
  RESULTS
  55 patients were included. 18F-FDG PET/CT changed staging in 6/55 (10.9%) patients who were upstaged to extensive disease. TTLG (>443.8) was a significant variable for OS with HR=2.1 (CI 1.14-3.871, p=0.017). Patients with TTLG>443.8 had a median OS of 13.4 months compared to 25.7 months in patients with TTLG<443.8 (p=0.018). TMTV (>72.4) was significant for PFS with HR=2.3 (CI 1.11-4.8, p=0.025). A median PFS of 12.1 and 26.2 months was found with TMTV greater and less than 72.4, respectively (p=0.005).
  
  
  CONCLUSIONS
  18F-FDG PET/CT improved staging of patients with SCLC, and TTLG and TMTV can be used as prognostic variables for OS and PFS, respectively.
  
  
  CONCLUSIONS
  • Identifying variables that predict the prognosis of patients with SCLC is important. • 18F-FDG PET/CT influences staging of patients with SCLC. • Metabolic parameters could be used as predictors for PFS and OS.
authors.affiliation: Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Zer
authors.affiliation: Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel. liranura@gmail.com.|Beilinson Hospital, 39 Jabotinski St., Petah Tikva, 4941492, Israel. liranura@gmail.com.
authors.forename: L
authors.identifier: http://orcid.org/0000-0001-8038-8161
authors.initials: L
authors.lastname: Domachevsky
authors.affiliation: Department of Radiology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Rapson
authors.affiliation: Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Nidam
authors.affiliation: Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Flex
authors.affiliation: Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: A M
authors.initials: AM
authors.lastname: Allen
authors.affiliation: Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: S M
authors.initials: SM
authors.lastname: Stemmer
authors.affiliation: Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Groshar
authors.affiliation: Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: H
authors.initials: H
authors.lastname: Bernstine
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000494:pharmacology; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG PET/CT; Metabolic parameters; Overall survival; Progression-free survival; Small cell lung cancer