RATIONALE AND OBJECTIVES: Stage IV non-small-cell lung cancer (NSCLC) consists of a heterogeneous group of patients with different prognoses. We assessed the prognostic value of baseline whole body tumor burden as measured by metabolic tumor volume (MTV), total lesion glycolysis (TLG), and standardized uptake values (SUV(max) and SUV(mean)) of all tumors in nonsurgical patients with Stage IV NSCLC. MATERIALS AND METHODS: Ninety-two consecutive patients with newly diagnosed Stage IV NSCLC who had a pretreatment F-18 fludeoxyglucose positron emission tomography/computed tomography scan were retrospectively reviewed. The MTV, TLG, SUV(mean), and SUV(max) of whole-body (WB) tumors were measured with the MIMvista workstation with manual adjustment. RESULTS: There was a statistically significant association between overall survival (OS) and ln(MTV)/ln(TLG) at the level of WB tumor burden (MTV(WB)) and of primary tumor (MTV(T)). The hazard ratio (HR) for a 1-unit increase of ln(MTV(WB)) and ln(MTV(T)) before and after adjusting for age and gender was 1.48/1.48 (both P < .001) and 1.25/1.25 (P = .006, .007), respectively. The HR for a 1-unit increase of ln(TLG(WB)) and ln(TLG(T)) before and after adjusting for age and gender was 1.37/1.37 (both P = .001) and 1.19/1.19 (P = .001, .017), respectively. There was no statistically significant association between OS and ln(SUV(max)) and ln(SUV(mean)) at WB tumor burden, primary tumor, nodal metastasis, or distant metastasis (P > .05). There was low interobserver variability between two radiologists with concordance correlation coefficients of 0.90 for ln(MTV(WB)) and greater than 0.90 for SUV(maxWB), SUV(meanWB), and ln(TLG(WB)). CONCLUSION: Baseline WB metabolic tumor burden, as measured with MTV and TLG, is a prognostic measurement in patients within Stage IV NSCLC with low interobserver variability. This study also suggests pretreatment MTV and TLG measurements may be used to further stratify patients with Stage IV NSCLC and are better prognostic measures than SUV(max) and SUV(mean) measurements.
RATIONALE AND OBJECTIVES: Stage IV non-small-cell lung cancer (NSCLC) consists of a heterogeneous group of patients with different prognoses. We assessed the prognostic value of baseline whole body tumor burden as measured by metabolic tumor volume (MTV), total lesion glycolysis (TLG), and standardized uptake values (SUV(max) and SUV(mean)) of all tumors in nonsurgical patients with Stage IV NSCLC. MATERIALS AND METHODS: Ninety-two consecutive patients with newly diagnosed Stage IV NSCLC who had a pretreatment F-18 fludeoxyglucose positron emission tomography/computed tomography scan were retrospectively reviewed. The MTV, TLG, SUV(mean), and SUV(max) of whole-body (WB) tumors were measured with the MIMvista workstation with manual adjustment. RESULTS: There was a statistically significant association between overall survival (OS) and ln(MTV)/ln(TLG) at the level of WB tumor burden (MTV(WB)) and of primary tumor (MTV(T)). The hazard ratio (HR) for a 1-unit increase of ln(MTV(WB)) and ln(MTV(T)) before and after adjusting for age and gender was 1.48/1.48 (both P < .001) and 1.25/1.25 (P = .006, .007), respectively. The HR for a 1-unit increase of ln(TLG(WB)) and ln(TLG(T)) before and after adjusting for age and gender was 1.37/1.37 (both P = .001) and 1.19/1.19 (P = .001, .017), respectively. There was no statistically significant association between OS and ln(SUV(max)) and ln(SUV(mean)) at WB tumor burden, primary tumor, nodal metastasis, or distant metastasis (P > .05). There was low interobserver variability between two radiologists with concordance correlation coefficients of 0.90 for ln(MTV(WB)) and greater than 0.90 for SUV(maxWB), SUV(meanWB), and ln(TLG(WB)). CONCLUSION: Baseline WB metabolic tumor burden, as measured with MTV and TLG, is a prognostic measurement in patients within Stage IV NSCLC with low interobserver variability. This study also suggests pretreatment MTV and TLG measurements may be used to further stratify patients with Stage IV NSCLC and are better prognostic measures than SUV(max) and SUV(mean) measurements.
Authors: Hao Zhang; Kristen Wroblewski; Yulei Jiang; Bill C Penney; Daniel Appelbaum; Cassie A Simon; Ravi Salgia; Yonglin Pu Journal: Lung Cancer Date: 2015-04-09 Impact factor: 5.705
Authors: Yonglin Pu; James X Zhang; Haiyan Liu; Daniel Appelbaum; Jianfeng Meng; Bill C Penney Journal: Eur J Nucl Med Mol Imaging Date: 2018-06-07 Impact factor: 9.236
Authors: Xuee Zhu; Chuanhong Liao; Bill C Penney; Feng Li; Mark K Ferguson; Cassie A Simon; Tianming Wu; Haiyan Liu; Yonglin Pu Journal: Nucl Med Commun Date: 2017-02 Impact factor: 1.690
Authors: Chenpeng Zhang; Chuanhong Liao; Bill C Penney; Daniel E Appelbaum; Cassie A Simon; Yonglin Pu Journal: Radiology Date: 2015-01-14 Impact factor: 11.105
Authors: Mitchell Machtay; Fenghai Duan; Barry A Siegel; Bradley S Snyder; Jeremy J Gorelick; Janet S Reddin; Reginald Munden; Douglas W Johnson; Larry H Wilf; Albert DeNittis; Nancy Sherwin; Kwan Ho Cho; Seok-Ki Kim; Gregory Videtic; Donald R Neumann; Ritsuko Komaki; Homer Macapinlac; Jeffrey D Bradley; Abass Alavi Journal: J Clin Oncol Date: 2013-09-16 Impact factor: 44.544
Authors: Christophe Van de Wiele; Vibeke Kruse; Peter Smeets; Mike Sathekge; Alex Maes Journal: Eur J Nucl Med Mol Imaging Date: 2012-11-14 Impact factor: 9.236