Tumor metabolic volume and total glycolytic activity and outcome in patients with lung cancer

Objectives To establish metabolic tumor volume and total glycolytic activity as prognostic biomarkers of outcome in patients with lung cancer.

Methods Thirty nine patients with lung cancer who had an initial staging PET/ CT at our institution between March 2007 and May 2009 were included in the study. Metabolic tumor volume and total glycolytic activity were measured by PET Edge, 38%, 50% and 60% SUVmax threshold segmentation techniques using MIMvista 3D contouring software. Unpaired t test was performed for between group analysis and Pearson correlation was performed between segmentation methods and survival time.

Results The mean age of patients (18 females and 21 males) was 67.6 (±10.6) years. The mean follow up time was 16.92 (±11.4) months. Twenty patients (51%) were dead and nineteen patients (49%) were alive. Stages of the cancers include stage 1 (n=10), stage 2 (n=6), stage 3 (n=16) and stage 4 (n=7). The mean SUVmax of patients who died was 12.7 (±3.6) and those alive was 13((±7.6) (p=0.9). The mean PET edge MTV of patients who died was 75 (95% CI 25.7-124) and those who alive was 21.9 (95% CI 5.2-38.6) (p=0.04). There were non significant results for all other segmentation methods for MTV and TGA. There was significant inverse correlation between 38% SUVmax threshold MTV and duration of survival (r = - 32%; p=0.05).

Conclusions Metabolic tumor volume segmented by PET edge and 38% SUVmax threshold method are prognostic markers of survival in lung cancer