title: Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients With Renal Cell Carcinoma.
abstract: OBJECTIVE
  We evaluated the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured using pretreatment F-FDG PET/CT in patients with renal cell carcinoma (RCC).
  
  
  METHODS
  A total of 139 patients with RCC who had undergone FDG PET/CT before tumor resection were retrospectively reviewed. We determined the SUVmax, MTV, and TLG and compared the results obtained with those required for a progression-free survival (PFS), which was defined as disease progression. Receiver operating characteristic curve analysis was used to compare prediction accuracies. Univariate and multivariate analyses of conventional clinicopathologic variables (age, sex, pathological tumor node metastasis [pTNM] stage, histological type, Fuhrman grade, and presence/absence of microscopic lymphatic and venous invasions) were used to compare the reliability of the metabolic parameters (SUVmax, MTV, and TLG).
  
  
  RESULTS
  Of the 139 patients, 24 patients (17%) experienced disease progression during the follow-up period. The age, pTNM stage, Fuhrman grade, presence/absence of microscopic lymphatic and venous invasions, SUVmax, MTV, and TLG were found to be significant prognostic factors for PFS (P < 0.05) on univariate analyses. Multivariate analyses revealed that MTV, TLG, and high pTNM stage (P = 0.02 [hazard ratio, 9.5; 95% confidence interval, 1.50-187.0], P = 0.02 [hazard ratio, 9.0; 95% confidence interval, 1.40-178.5], P = 0.004 [hazard ratio, 5.9; 95% confidence interval, 1.66-20.4], respectively) were the significant predictors after adjustment for other variables of PFS.
  
  
  CONCLUSIONS
  The pretreatment value of MTV, TLG, and high pTNM stage are the significant prognostic factors in patients with RCC.
authors.affiliation: From the *Departments of Diagnostic Imaging and Nuclear Medicine, and †Urology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Nakajima
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.forename: Koichiro
authors.initials: K
authors.lastname: Abe
authors.forename: Shuji
authors.initials: S
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18