Yonglin Pu1, James X Zhang2, Haiyan Liu3, Daniel Appelbaum4, Jianfeng Meng5, Bill C Penney4. 1. Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 2026, Chicago, IL, 60637, USA. ypu@radiology.bsd.uchicago.edu. 2. Department of Medicine, The University of Chicago, Chicago, IL, USA. 3. Department of Nuclear Medicine, First Hospital and Molecular Imaging Precision Medical Collaborative Innovation Center, Shanxi Medical University, Taiyuan, 030001, Shanxi, China. 4. Department of Radiology, The University of Chicago, 5841 S. Maryland Ave., MC 2026, Chicago, IL, 60637, USA. 5. Department of Respiratory Medicine, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, 541002, Guangxi Zhuang Autonomous Region, China.
Abstract
PURPOSE: We hypothesized that whole-body metabolic tumor volume (MTVwb) could be used to supplement non-small cell lung cancer (NSCLC) staging due to its independent prognostic value. The goal of this study was to develop and validate a novel MTVwb risk stratification system to supplement NSCLC staging. METHODS: We performed an IRB-approved retrospective review of 935 patients with NSCLC and FDG-avid tumor divided into modeling and validation cohorts based on the type of PET/CT scanner used for imaging. In addition, sensitivity analysis was conducted by dividing the patient population into two randomized cohorts. Cox regression and Kaplan-Meier survival analyses were performed to determine the prognostic value of the MTVwb risk stratification system. RESULTS: The cut-off values (10.0, 53.4 and 155.0 mL) between the MTVwb quartiles of the modeling cohort were applied to both the modeling and validation cohorts to determine each patient's MTVwb risk stratum. The survival analyses showed that a lower MTVwb risk stratum was associated with better overall survival (all p < 0.01), independent of TNM stage together with other clinical prognostic factors, and the discriminatory power of the MTVwb risk stratification system, as measured by Gönen and Heller's concordance index, was not significantly different from that of TNM stage in both cohorts. Also, the prognostic value of the MTVwb risk stratum was robust in the two randomized cohorts. The discordance rate between the MTVwb risk stratum and TNM stage or substage was 45.1% in the modeling cohort and 50.3% in the validation cohort. CONCLUSION: This study developed and validated a novel MTVwb risk stratification system, which has prognostic value independent of the TNM stage and other clinical prognostic factors in NSCLC, suggesting that it could be used for further NSCLC pretreatment assessment and for refining treatment decisions in individual patients.
PURPOSE: We hypothesized that whole-body metabolic tumor volume (MTVwb) could be used to supplement non-small cell lung cancer (NSCLC) staging due to its independent prognostic value. The goal of this study was to develop and validate a novel MTVwb risk stratification system to supplement NSCLC staging. METHODS: We performed an IRB-approved retrospective review of 935 patients with NSCLC and FDG-avid tumor divided into modeling and validation cohorts based on the type of PET/CT scanner used for imaging. In addition, sensitivity analysis was conducted by dividing the patient population into two randomized cohorts. Cox regression and Kaplan-Meier survival analyses were performed to determine the prognostic value of the MTVwb risk stratification system. RESULTS: The cut-off values (10.0, 53.4 and 155.0 mL) between the MTVwb quartiles of the modeling cohort were applied to both the modeling and validation cohorts to determine each patient's MTVwb risk stratum. The survival analyses showed that a lower MTVwb risk stratum was associated with better overall survival (all p < 0.01), independent of TNM stage together with other clinical prognostic factors, and the discriminatory power of the MTVwb risk stratification system, as measured by Gönen and Heller's concordance index, was not significantly different from that of TNM stage in both cohorts. Also, the prognostic value of the MTVwb risk stratum was robust in the two randomized cohorts. The discordance rate between the MTVwb risk stratum and TNM stage or substage was 45.1% in the modeling cohort and 50.3% in the validation cohort. CONCLUSION: This study developed and validated a novel MTVwb risk stratification system, which has prognostic value independent of the TNM stage and other clinical prognostic factors in NSCLC, suggesting that it could be used for further NSCLC pretreatment assessment and for refining treatment decisions in individual patients.
Authors: Shengri Liao; Bill C Penney; Kristen Wroblewski; Hao Zhang; Cassie A Simon; Rony Kampalath; Ming-Chi Shih; Naoko Shimada; Sheng Chen; Ravi Salgia; Daniel E Appelbaum; Kenji Suzuki; Chin-Tu Chen; Yonglin Pu Journal: Eur J Nucl Med Mol Imaging Date: 2011-09-23 Impact factor: 9.236
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: Hao Zhang; Kristen Wroblewski; Shengri Liao; Rony Kampalath; Bill C Penney; Yi Zhang; Yonglin Pu Journal: Acad Radiol Date: 2012-09-19 Impact factor: 3.173
Authors: Sara Carvalho; Ralph T H Leijenaar; Emmanuel Rios Velazquez; Cary Oberije; Chintan Parmar; Wouter van Elmpt; Bart Reymen; Esther G C Troost; Michel Oellers; Andre Dekker; Robert Gillies; Hugo J W L Aerts; Philippe Lambin Journal: Acta Oncol Date: 2013-09-09 Impact factor: 4.089