title: Prognostic value of pretreatment volume-based quantitative18F-FDG PET/CT parameters in patients with malignant pleural mesothelioma.
abstract: OBJECTIVE
  To investigate the relationships between pretreatment volume-based quantitative18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters and overall survival (OS) in patients with malignant pleural mesothelioma (MPM).
  
  
  METHODS
  We retrospectively reviewed data from 201 MPM patients, of whom 38 underwent surgical resection, and calculated the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), including primary tumors and nodal or distant metastatic lesions, on pretreatment18F-FDG PET/CT. Relationships between clinicopathological factors (age, sex, performance status, European Organization for Research and Treatment of Cancer [EORTC] score, histological subtype, TNM stage, and treatment strategy), volume-based quantitative PET/CT parameters, and OS were evaluated using a Cox proportional hazards model and log-rank test.
  
  
  RESULTS
  The median follow-up was 15 months (range, 1-96 months; median, 17 months). In a univariate analysis of all patients, older age (p<0.05), high EORTC score (p<0.001), non-epithelioid histological subtype (p<0.001), high T stage (p<0.001), positive N/M status (p<0.05, p<0.001), advanced TNM stage (p<0.001), non-surgical treatment (p<0.001), and high SUVmax (p<0.001), MTV (p<0.001), or TLG (p<0.001) were associated with significantly shorter OS. A multivariate analysis confirmed non-epithelioid subtype (hazard ratio [HR]: 1.69, 95% confidence interval [CI]: 1.14-2.48; p<0.05), non-surgical treatment (HR: 0.58, 95% CI: 0.34-0.95; p<0.05), and high TLG (HR: 1.97, 95% CI: 1.14-3.44; p<0.05) as independent negative predictors.
  
  
  CONCLUSIONS
  Pretreatment volume-based quantitative18F-FDG PET/CT parameters, especially TLG, could serve as potential surrogate markers for MPM prognosis.
authors.affiliation: Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Hyogo, Japan. Electronic address: kitajima@med.kobe-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Radiology, Hyogo College of Medicine, Hyogo, Japan. Electronic address: h-doi@hyo-med.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.affiliation: Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. Electronic address: kuririn@hyo-med.ac.jp.
authors.forename: Kozo
authors.initials: K
authors.lastname: Kuribayashi
authors.affiliation: Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan. Electronic address: kogekogemasaki@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo, Japan. Electronic address: tty-823@hyo-med.ac.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tsuchitani
authors.affiliation: Department of Radiological Technology, Hyogo College of Medicine College Hospital, Hyogo, Japan. Electronic address: masao1108@gmail.com.
authors.forename: Masao
authors.initials: M
authors.lastname: Tanooka
authors.affiliation: Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Hyogo, Japan. Electronic address: fukuchan00106@gmail.com.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Fukushima
authors.affiliation: Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. Electronic address: t-nakano@hyo-med.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Thoracic Surgery, Hyogo College of Medicine, Hyogo, Japan. Electronic address: hasegawa@hyo-med.ac.jp.
authors.forename: Seiki
authors.initials: S
authors.lastname: Hasegawa
authors.affiliation: Department of Radiology, Hyogo College of Medicine, Hyogo, Japan. Electronic address: hirota-s@hyo-med.ac.jp.
authors.forename: Shozo
authors.initials: S
authors.lastname: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis / Q000502:physiology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000473:pathology* / Q000628:therapy; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Malignant pleural mesothelioma; Maximum standardized uptake value; Metabolic tumor volume; Survival; Total lesion glycolysis