Article Figures & Data
Figures
- FIGURE 1.
Coronal, sagittal, and transaxial slices (left to right) through bone marrow of a patient with NSCLC showing markedly increased bone marrow metabolism on 18F-FDG PET. Qualitatively, bone marrow activity is remarkably greater than mean liver activity.
- FIGURE 2.
Kaplan–Meier survival curves of NSCLC patients with bone marrow hypermetabolism (BM SUV > 1.7) on 18F-FDG PET vs. patients with normal bone marrow metabolism. BM SUV is normalized for lean body mass (lbm). Median survival of patients with bone marrow hypermetabolism was significantly shorter than that of NSCLC patients with normal bone marrow metabolism (151 vs. 799 d; P = 0.00006, log-rank test). BM = bone marrow.
- FIGURE 3.
Kaplan–Meier survival curves of NSCLC patients with high tumor SUV (weight-corrected mean SUVT > 10) on 18F-FDG PET vs. patients with less active primary tumors. Median survival of patients with elevated SUVT was significantly shorter (227 vs. 874 d; P = 0.003, log-rank test). T = primary tumor.
Tables
Variable % Median Range Age (y) 68 34–89 Sex Male 66 Female 44 LDH (IU/L) 490 220–1,272 Albumin (g/L) 32.3 17.6–44.1 Calcium (mmol/L) 2.35 1.23–3.11 Hemoglobin (g/L) 137 82–169 WBCs (× 1012/L) 7.9 3.7–29.9 Platelets (× 1012/L) 247 75–697 Histologic subtype Adenocarcinoma 49 Squamous cell 38 Large cell 12 Mixed* 1 18F-FDG stage 1 24.2 2 10.8 3 32.5 4 32.5 Mean SUVT (weight corrected) 6.2 1.4–23 BM SUV (LBM corrected) 1.5 0.6–3.2 BM/L ratio 1 0.6–2.4 Treatment Surgical (n = 43) 36 Nonsurgical (n = 77) 64 ↵* Adenocarcinoma + squamous cell.
LBM = lean body mass.
Factor n Median survival (d) 95% confidence interval P Platelets 0.0000002 <160 5 60 38–NA ≥160 72 613 409–915 Hemoglobin 0.000001 <90 3 50 38–NA ≥90 75 553 318–874 BM SUV (LBM corrected) 0.00006 <1.7 103 799 555–1,209 ≥1.7 16 151 83–690 BM/L ratio 0.00004 <1.5 109 724 553–1,094 ≥1.5 10 178 28–NA 18F-FDG N factor 0.002 N0–N1 68 1,071 741–1,457 N2–N3 52 286 230–667 LDH 0.002 <609 75 716 497–1,209 ≥609 19 237 122–741 SUVT (weight corrected) 0.003 <10 99 874 555–1,182 ≥10 21 227 122–690 Sex 0.003 Male 79 523 318–799 Female 41 1,457 724–NA 18F-FDG stage 0.01 1–2 52 1,092 789–1,582 3–4 68 371 242–690 Age (y) 0.02 <60 35 1,087 295–NA ≥60 85 641 452–874 Thrombocytosis 0.01 <345 67 630 409–915 ≥345 10 224 89–NA Hypercalcemia 0.02 <2.5 76 716 498–1,092 ≥2.5 8 323 107–NA Albumin 0.02 <35 29 318 178–741 ≥35 12 789 483–NA 18F-FDG M factor 0.04 M0 81 838 613–1,209 M1 39 371 124–874 Leukocytosis 0.03 <12.5 68 613 409–915 ≥12.5 9 224 109–NA 18F-FDG T factor 0.01 T1 57 1,058 716–1,582 T2–T4 63 409 242–799 NA = not available (cannot be calculated).
pTNM (P = 0.003), pN factor (P = 0.006), and pT factor (P = 0.02) were not included in multivariate analysis.
Factor n Median survival (d) 95% confidence interval P Surgical treatment vs. nonsurgical 0.0000003 Surgical 43 1,582 1,259–NA Nonsurgical 77 338 237–641 Nonsurgical treatment NS Radiotherapy or chemotherapy 40 409 242–716 None 37 286 122–838 Surgical treatment BM/L ratio 0.048 BM SUV NS SUVT NS Nonsurgical treatment BM/L ratio 0.000001 BM SUV 0.0004 SUVT 0.01 NA = not available (cannot be calculated); NS = not significant.
Factor RR 95% confidence interval P BM SUV 1.6 1.1–2.3 0.008 Leukocytosis 1.6 1.1–2.3 0.02 Anemia 3.4 1.6–7.0 0.001 Thrombocytopenia 3.7 2.1–6.6 0.000007 Thrombocytosis 1.5 1.0–2.3 0.04 18F-FDG N factor 1.5 1.2–2.3 0.007 RR = relative risk.
BM SUV BM/L ratio SUVT Factor Spearman correlation coefficient BM SUV 1 0.76 0.20 BM/L ratio 0.76 1 NS SUVT 0.20 NS 1 WBCs 0.38 0.49 NS Hemoglobin −0.30 NS NS Platelets 0.24 0.30 NS Pao2 (%) −0.45 NS NS Time after injection 0.19 0.25 0.20 Fisher exact test (P value) 18F-FDG T factor NS 0.03 0.003 18F-FDG N factor NS NS 0.03 18F-FDG stage NS NS 0.02 CI T factor NS NS 0.004 CI N factor 0.02 NS 0.03 NS = not significant; CI = confidence interval.
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