Christian Philipp Reinert1, Sergios Gatidis2, Julia Sekler2, Helmut Dittmann3, Christina Pfannenberg2, Christian la Fougère3,4,5, Konstantin Nikolaou2,4,5, Andrea Forschner6. 1. Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. christian.reinert@med.uni-tuebingen.de. 2. Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. 3. Department of Radiology, Nuclear Medicine and Clinical Molecular Imaging, University Hospital, Tübingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. 4. Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany. 5. German Cancer Consortium (DKTK). Partner Site Tübingen, Tübingen, Germany. 6. Department of Dermatology, University Hospital Tübingen, Liebermeisterstrasse 25, 72076, Tübingen, Germany.
Abstract
BACKGROUND: To investigate the association of tumor volumetric parameters in melanoma patients undergoing 18F-FDG-PET/CT with serologic tumor markers and inflammatory markers and the role as imaging predictors for overall survival. METHODS: A patient cohort with advanced melanoma undergoing 18F-FDG-PET/CT for planning metastasectomy between 04/2013 and 01/2015 was retrospectively included. The volumetric PET parameters whole-body MTV and whole-body TLG as well as the standard uptake value (SUV) peak were quantified using 50%-isocontour volumes of interests (VOIs) and then correlated with the serologic parameters lactate dehydrogenase (LDH), S-100 protein, c-reactive protein (CRP) and alkaline phosphatase (AP). PET parameters were dichotomized by their respective medians and correlated with overall survival (OS) after PET/CT. OS was compared between patients with or without metastases and increased or not-increased serologic parameters. RESULTS: One hundred seven patients (52 female; 65 ± 13.1yr.) were included. LDH was strongly associated with MTV (rP = 0.73, p < 0.001) and TLG (rP = 0.62, p < 0.001), and moderately associated with SUVpeak (rP = 0.55, p < 0.001). S-100 protein showed a moderate association with MTV (rP = 0.54, p < 0.001) and TLG (rP = 0.48, p < 0.001) and a weak association with SUVpeak (rP = 0.42, p < 0.001). A strong association was observed between CRP and MTV (rP = 0.66, p < 0.001) and a moderate to weak association between CRP and TLG (rP = 0.53, p < 0.001) and CRP and SUVpeak (rP = 0.45, p < 0.001). For differentiation between patients with or without metastases, receiver operating characteristic (ROC) analysis revealed a cut-off value of 198 U/l for serum LDH (AUC 0.81, sensitivity 0.80, specificity 0.72). Multivariate analysis for OS revealed that both MTV and TLG were strong independent prognostic factors. TLG, MTV and SUVpeak above patient median were accompanied with significantly reduced estimated OS compared to the PET parameters below patient median (e.g. TLG: 37.1 ± 3.2 months vs. 55.9 ± 2.5 months, p < 0.001). Correspondingly, both elevated serum LDH and S-100 protein were accompanied with significantly reduced OS (36.5 ± 4.9 months and 37.9 ± 4.4 months) compared to normal serum LDH (49.2 ± 2.4 months, p = 0.01) and normal S-100 protein (49.0 ± 2.5 months, p = 0.01). CONCLUSIONS: Tumor volumetric parameters in 18F-FDG-PET/CT serve as prognostic imaging biomarkers in patients with advanced melanoma which are associated with established serologic tumor markers and inflammatory markers.
BACKGROUND: To investigate the association of tumor volumetric parameters in melanomapatients undergoing 18F-FDG-PET/CT with serologic tumor markers and inflammatory markers and the role as imaging predictors for overall survival. METHODS: A patient cohort with advanced melanoma undergoing 18F-FDG-PET/CT for planning metastasectomy between 04/2013 and 01/2015 was retrospectively included. The volumetric PET parameters whole-body MTV and whole-body TLG as well as the standard uptake value (SUV) peak were quantified using 50%-isocontour volumes of interests (VOIs) and then correlated with the serologic parameters lactate dehydrogenase (LDH), S-100 protein, c-reactive protein (CRP) and alkaline phosphatase (AP). PET parameters were dichotomized by their respective medians and correlated with overall survival (OS) after PET/CT. OS was compared between patients with or without metastases and increased or not-increased serologic parameters. RESULTS: One hundred seven patients (52 female; 65 ± 13.1yr.) were included. LDH was strongly associated with MTV (rP = 0.73, p < 0.001) and TLG (rP = 0.62, p < 0.001), and moderately associated with SUVpeak (rP = 0.55, p < 0.001). S-100 protein showed a moderate association with MTV (rP = 0.54, p < 0.001) and TLG (rP = 0.48, p < 0.001) and a weak association with SUVpeak (rP = 0.42, p < 0.001). A strong association was observed between CRP and MTV (rP = 0.66, p < 0.001) and a moderate to weak association between CRP and TLG (rP = 0.53, p < 0.001) and CRP and SUVpeak (rP = 0.45, p < 0.001). For differentiation between patients with or without metastases, receiver operating characteristic (ROC) analysis revealed a cut-off value of 198 U/l for serum LDH (AUC 0.81, sensitivity 0.80, specificity 0.72). Multivariate analysis for OS revealed that both MTV and TLG were strong independent prognostic factors. TLG, MTV and SUVpeak above patient median were accompanied with significantly reduced estimated OS compared to the PET parameters below patient median (e.g. TLG: 37.1 ± 3.2 months vs. 55.9 ± 2.5 months, p < 0.001). Correspondingly, both elevated serum LDH and S-100 protein were accompanied with significantly reduced OS (36.5 ± 4.9 months and 37.9 ± 4.4 months) compared to normal serum LDH (49.2 ± 2.4 months, p = 0.01) and normal S-100 protein (49.0 ± 2.5 months, p = 0.01). CONCLUSIONS:Tumor volumetric parameters in 18F-FDG-PET/CT serve as prognostic imaging biomarkers in patients with advanced melanoma which are associated with established serologic tumor markers and inflammatory markers.
Authors: Marco Cesati; Francesca Scatozza; Daniela D'Arcangelo; Gian Carlo Antonini-Cappellini; Stefania Rossi; Claudio Tabolacci; Maurizio Nudo; Enzo Palese; Luigi Lembo; Giovanni Di Lella; Francesco Facchiano; Antonio Facchiano Journal: Cancers (Basel) Date: 2020-12-08 Impact factor: 6.639
Authors: Khanyisile N Hlongwa; Kgomotso M G Mokoala; Zvifadzo Matsena-Zingoni; Mariza Vorster; Mike M Sathekge Journal: Diagnostics (Basel) Date: 2022-02-25