Prognostic value of metabolic tumor volume of 18F-FDG PET/CT in advanced NSCLC

Objectives Evaluate the prognostic value of metabolic tumor volume(MTV)of 18F-FDG PET/CT in patients with advanced non small cell lung cancer.

Methods 110 advanced NSCLC patients who underwent pretreatment 18F-FDG PET/CT scan were reviewed retrospectively. MTV and SUVmax of the primary tumor were measured by 18F-FDG PET. The survival rate analysis was assessed by Kaplan-Meier survival curve and log-rank test.The prognostic significance of MTV, SUVmax, and other clinicopathological variables was assessed by Cox proportional hazards regression analysis. To further evaluate and compare the predictive performance of PET parameters, MTV and SUVmax, time-dependent receiver operating characteristic curve (ROC) analysis was used.

Results Patients with smaller MTV(≤35cm3) had significantly better 2-year overall survival (P<0.001)than patients with larger foci MTV(>35cm3). In the univariate analysis, American Joint Committee on Cancer (AJCC) stage, MTV, and different pathology of primary tumor were significant predictors of survival. On multivariate analysis ,age, AJCC stage, MTV of primary tumor were significant predictors of survival. On time-dependent ROC analysis, MTV showed good predictive performance for overall survival better than SUVmax.and areas under the curve are respectly 0.649 and 0.523.

Conclusions The pilot study indicates that MTV of primary foci, a volumetric parameter of 18F-FDG PET, is an important independent prognostic factor for survival and a better predictor of survival than SUVmax in advanced NSCLC.

Research Support Natural Science Foundation of Shandong Province Key Laboratory of Shandong Provinc