Skip to main content

Advertisement

SpringerLink
Log in

Ratio of standardized uptake value on PET helps predict response and outcome after chemotherapy in advanced non-small cell lung cancer

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Background

The maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET) within the primary tumor may predict outcome in patients with surgically resected non-small cell lung cancer (NSCLC). However, it remains uncertain whether the SUVmax of the primary tumor predicts outcome after chemotherapy in advanced NSCLC. Thus, we evaluated the ratio of SUVmax of the metastatic tumor to the primary tumor (M/P ratio) to determine whether it could be a useful marker in predicting response and outcome after chemotherapy in advanced NSCLC.

Methods

Chemo-naïve patients with advanced NSCLC who had locoregional lymph nodes and/or distant metastases other than brain, were eligible for inclusion in this study. Response and survival were analyzed according to the SUVmax of primary tumor, the ratio of the SUVmax of the tumor to the mean SUV of the mediastinum (T/M ratio) and M/P ratio.

Results

One hundred and four consecutive patients were included in the retrospective study. Patients with high M/P ratio exhibited significantly lower response rates. The value of SUVmax and T/M ratio were not associated with the response to initial chemotherapy. In the univariate analysis, T/M ratio and SUVmax were significantly associated with poor outcome. However, the outcome of non-adenocarcinoma was unaffected by T/M ratio and SUVmax. Multivariate analysis confirmed that high M/P ratio was a significant independent factor predicting a poor outcome.

Conclusion

High M/P ratio was associated with a poor response to initial chemotherapy and was a significant independent factor in predicting poor outcome in advanced NSCLC patients with metastatic tumors other than in brain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ettinger DS. Overview and state of the art in the management of lung cancer. Oncology (Williston Park). 2004;18(Suppl 4):3–9.

    Google Scholar 

  2. Clinical Practice Guidelines for the Treatment of Unresectable Non-Small Cell Lung Cancer. Adopted on May 16, 1997 by the American Society of Clinical Oncology. J Clin Oncol. 1997;15:2996–3018.

    Google Scholar 

  3. Sasaki R, Komaki R, Macapinlac H, Erasmus J, Allen P, Forster K, et al. [18F] fluorodeoxyglucose uptake by positron emission tomography predicts outcome of non-small-cell lung cancer. J Clin Oncol. 2005;23:1136–43.

    Article  CAS  PubMed  Google Scholar 

  4. Vansteenkiste JF, Stroobants SG, Dupont PJ, De Leyn PR, Verbeken EK, Deneffe GJ, et al. Prognostic importance of the standardized uptake value on 18F-fluoro-2-deoxy-glucose-positron emission tomography in non-small cell lung cancer: an analysis of 125 cases. J Clin Oncol. 1999;17:3201–6.

    CAS  PubMed  Google Scholar 

  5. Berghmans T, Dusart M, Paesmans M, Hossein-Foucher C, Buvat I, Castaigne C, et al. Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European lung cancer working party for the IASLC Lung Cancer Staging Project. J Thorac Oncol. 2008;3:6–12.

    Article  PubMed  Google Scholar 

  6. Hoang JK, Hoagland LF, Coleman RE, Coan AD, Herndon JE 2nd, Patz EF Jr. Prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography imaging in patients with advanced-stage non-small-cell lung carcinoma. J Clin Oncol. 2008;26:1459–64.

    Article  PubMed  Google Scholar 

  7. Lee KH, Lee SH, Kim DW, Kang WJ, Chung JK, Im SA, et al. High fluorodeoxyglucose uptake on positron emission tomography in patients with advanced non-small cell lung cancer on platinum-based combination chemotherapy. Clin Cancer Res. 2006;12:4232–6.

    Article  CAS  PubMed  Google Scholar 

  8. Na II, Byun BH, Kang HJ, Cheon GJ, Koh JS, Kim CH, et al. 18F-fluoro-2-deoxy-glucose uptake predicts clinical outcome in patients with gefitinib-treated non-small cell lung cancer. Clin Cancer Res. 2008;14:2036–41.

    Article  CAS  PubMed  Google Scholar 

  9. Vesselle H, Freeman JD, Wiens L, Stern J, Nguyen HQ, Hawes SE, et al. Fluorodeoxyglucose uptake of primary non-small cell lung cancer at positron emission tomography: new contrary data on prognostic role. Clin Cancer Res. 2007;13:3255–63.

    Article  CAS  PubMed  Google Scholar 

  10. Kaira K, Oriuchi N, Shimizu K, Ishikita T, Higuchi T, Imai H, et al. Evaluation of thoracic tumors with 18F-FMT and 18F-FDG PET-CT: a clinicopathological study. Int J Cancer. 2009;124:1152–60.

    Article  CAS  PubMed  Google Scholar 

  11. Endo M, Nakagawa K, Ohde Y, Okumura T, Kondo H, Igawa S, et al. Utility of 18FDG-PET for differentiating the grade of malignancy in thymic epithelial tumors. Lung Cancer. 2008;61:350–5.

    Article  PubMed  Google Scholar 

  12. Cerfolio RJ, Bryant AS. Ratio of the maximum standardized uptake value of FDG-PET of the mediastinal (N2) lymph nodes to the primary tumor may be a universal predictor of nodal malignancy in patients with nonsmall-cell lung cancer. Ann Thorac Surg. 2007;83:1826–30.

    Article  PubMed  Google Scholar 

  13. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest. 1997;111:1718–23.

    Article  CAS  PubMed  Google Scholar 

  14. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst. 2000;92:205–16.

    Article  CAS  PubMed  Google Scholar 

  15. Okereke IC, Gangadharan SP, Kent MS, Nicotera SP, Shen C, DeCamp MM. Standard uptake value predicts survival in non-small cell lung cancer. Ann Thorac Surg. 2009;88:911–6.

    Article  PubMed  Google Scholar 

  16. Sekine I, Nokihara H, Yamamoto N, Kunitoh H, Ohe Y, Tamura T. Comparative chemotherapeutic efficacy in non-small cell lung cancer patients with postoperative recurrence and stage IV disease. J Thorac Oncol. 2009;4:518–21.

    Article  PubMed  Google Scholar 

  17. Kaira K, Oriuchi N, Shimizu K, Tominaga H, Yanagitani N, Sunaga N, et al. 18F-FMT uptake seen within primary cancer on PET helps predict outcome of non-small cell lung cancer. J Nucl Med. 2009;50:1770–6.

    Article  PubMed  Google Scholar 

  18. Kaira K, Oriuchi N, Yanagitani N, Sunaga N, Ishizuka T, Mori M, et al. Assessment of therapy response in lung cancer with fluorine-18-α-methyl tyrosine positron emission tomography. AJR Am J Roentgenol 2010 (in press).

Download references

Conflict of interest

None of the authors have any financial or personal relationships with other people or organizations that could inappropriately influence this work.

Author information

Authors and Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Kyoichi Kaira, Asuka Tsuya, Yukiko Nakamura, Tateaki Naito, Haruyasu Murakami, Toshiaki Takahashi & Nobuyuki Yamamoto

  2. Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Masahiro Endo & Koiku Asakura

Authors
  1. Kyoichi Kaira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masahiro Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Koiku Asakura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Asuka Tsuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yukiko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tateaki Naito
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haruyasu Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Toshiaki Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nobuyuki Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyoichi Kaira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaira, K., Endo, M., Asakura, K. et al. Ratio of standardized uptake value on PET helps predict response and outcome after chemotherapy in advanced non-small cell lung cancer. Ann Nucl Med 24, 697–705 (2010). https://doi.org/10.1007/s12149-010-0412-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-010-0412-8

Keywords

Search

Navigation