International Journal of Hematology and Oncology 2020, Vol 30, Num 3 Page(s): 162-170
Do Volume-Based and Metabolic 18F FDG PET/CT Parameters Identify Groups at Risk for Poor Prognosis in Patients with Newly Diagnosed Metastatic and Non-Metastatic Non-Small Cell Lung Cancer?

Osman KUPIK1, Mehmet BOZKURT2, Sertac ASA3, Gulnihan EREN4, Hasan Gundogdu5, Medeni ARPA6

1Recep Tayyip Erdoğan University- Faculty of Medicine, Department of Nuclear Medicine, Rize, TURKEY
2University of Health Sciences, Faculty of Medicine, Department of Nuclear Medicine, Istanbul, TURKEY
3Istanbul University-Cerrahpasa, Faculty of Medicine, Department of Nuclear Medicine, Istanbul, TURKEY
4University of Sıtkı Kocman, Faculty of Medicine, Department of Radiation Oncology, Muğla, TURKEY
5Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Radiology, Rize, TURKEY
6Recep Tayyip Erdoğan University, Faculty of Medicine, Department of Biochemistry, Rize, TURKEY

Keywords: 18F FDG PET/CT, Non-small cell lung cancer, Metastasis, Prognosis, Survival
To determine the relationship between 18F FDG PET/CT parameters of the primary tumor/nodal metastasis/distant metastasis and overall survival (OS) of patients with newly diagnosed non-small cell lung cancer (NSCLC). Data from 159 patients with newly diagnosed NSCLC who underwent pretreatment 18F FDG PET/CT were analyzed. The SUVmax, SUVmean, the metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor, lymph node metastasis, and distant metastasis were measured. The total MTV and total TLG were calculated. The optimal cut-off values of the 18F FDG PET/CT parameters were determined using receiver operating characteristics curve analysis. Kaplan-Meier curves were used to determine OS. There were a total of 101 deaths during the follow-up (range, 3.7-54.2 months). The median OS was 26.4 months for the entire group, 11.8 months for patients with metastasis, and 41 months for patients with no metastasis (p< 0.001). In all patients (n= 159), nodal SUVmax (SUVmaxN), total TLG, and the presence of distant metastasis were independent predictors. The 2-year OS for patients with TLG ≥ 328 and TLG < 328 were 32% and 80%, respectively. Independent predictors for OS were found as SUVmaxN in the group of patients with distant metastasis, and SUVmax, MTV of the primary tumor (MTVT), and lymph node size (LNsize) in the group of patients without distant metastasis. 18F FDG PET/CT may distinguish patients with high risk for poor prognosis in patients with and without metastasis.