Prognostic Value of Volumetric and Textural Parameters measured by Pretreatment F-18 FDG PET/CT in Patients with Renal Cell Carcinoma

Objectives The aim of this retrospective study was to determine whether volumetric and textural parameters assessed by pretreatment F-18 FDG PET/CT provides prognostic information independent of established prognostic factors in patients with renal cell carcinoma

Methods I reviewed retrospectively the medical records of 24 patients (men 15, women 9, mean age 64.8±12.5 years) with pathologic proven clear cell renal cell carcinoma. They underwent F-18 FDG PET/CT as part of a pretreatment workup from Februry 2007 to July 2012. For the analysis, patients were classified by age, sex, tumor size, nuclear grade, stage by AJCC, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and coefficient of variation (COV). The relationship between volumetric, textural parameters and survival was analyzed using the Kaplan-Meier with log-Rank test and Cox’s proportional-hazard regression methods.

Results Median survival for all 24 study subjects was 551 days and median SUVmax was 3.75 (range: 2-15.6). Patients with SUVmax of ≤3.75 survived significantly longer than patients with SUVmax of >3.75 ( Median 1572 vs. 360 days, P = 0.005). High MTV, TLG and COV also showed a poor overall survival (OS) than that of the lower parameter group. In univariate analysis the OS was found to be significantly related to age (P = 0.014), stage (P = 0.001), tumor size (P = 0.038), SUVmax (P = 0.004), MTV (P = 0.012), TLG (P = 0.001) and COV (P = 0.006). Multivariate analysis study revealed that the patients with higher SUVmax (P = 0.041, CI = 1.08 to 33.47, HR = 6.01), TLG (P = 0.003, CI = 2.93 to 252.43, HR = 27.19) and COV (P = 0.035, CI = 1.21 to 137.07, HR = 12.88) showed worse OS.

Conclusions SUVmax, TLG and COV derived from pretreatment F-18 FDG PET/CT contribute independent prognostic information on overall survival in patients with renal cell carcinoma.