Prognostic value of SUVmax measurements obtained by FDG-PET in patients with non-small cell lung cancer receiving chemotherapy

7214 Background: The SUV is a measure for the preferential uptake of a radiopharmaceutical in a tumor compared with a homogenous distribution in a body. SUV can be based on the maximum value (SUVmax) or on the mean value in a region outlined by isodensity contours, e.g., 70% and 50%. The prognostic value of the different SUVs in non-small cell lung cancer (NSCLC) is not clear. We evaluated the prognostic value of SUVmax, SUV 70% and SUV 50% in patients (pts) with resectable NSCLC. Methods: All consecutive pts who underwent an attenuation corrected whole body FDG-PET scan were selected. All data were reconstructed iteratively. Only pts with stage I through IIIA NSCLC were included. By adjusting the isocontour in the region of interest, the SUVmax, SUV 70% and SUV 50% of the primary tumor were calculated. Cox regression analysis was used to calculate the relation between the different SUVs and survival. Results: Eighty-four pts (67 males, median age 64 years, range 38–86) were included. Histology was squamous cell carcinoma (n = 43), adenocarcinoma (n = 27), large cell carcinoma (n = 13), and 1 patient with bronchoalveolar carcinoma. Nineteen pts had stage IA, 28 stage IB, 4 stage IIA, 19 stage IIB, and 14 stage IIIA. Median (range) SUVmax, SUV 70%, and SUV 50% were 6.9 (1.6–32.5), 5.5 (1.0–23.2), and 4.5 (0.9–21.9), respectively. Analysis of residuals of SUVmax as a continuous variable suggests no cut-off point and no indication of time-dependency. By univariate analysis, all pts with a SUV higher than the median value had a worse survival than pts with a SUV lower than median (Hazard ratio’s for SUVmax, SUV70% and SUV 50% were 2.3 (p = 0.024), 2.5 (p = 0.015), and 2.7 (p = 0.010), respectively). Conclusions: SUVmax, SUV 70% and SUV 50% measured with FDG-PET have a similar prognostic impact. No cut-off point for SUVmax has been observed. No significant financial relationships to disclose.

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Prognostic value of various metabolic parameters on pre-treatment 18-F-FDG PET/CT in patients with stage I-III non-small cell lung cancer

Internatuinal Journal of Radiation Research ◽

10.52547/ijrr.18.4.799 ◽

2020 ◽

Vol 18 (4) ◽

pp. 799-807

Author(s):

F. Demir ◽

A. Yanarateş ◽

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Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Small Cell ◽

Small Cell Lung ◽

Pet Ct ◽

Pre Treatment ◽

Fdg Pet Ct

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Prognostic Value of Immunotherapy-induced Organ Inflammation Assessed on 18FDG PET in Patients With Metastatic Non–small Cell Lung Cancer

10.21203/rs.3.rs-1188197/v1 ◽

2021 ◽

Author(s):

Olivier HUMBERT ◽

Matteo BAUCKNEHT ◽

Jocelyn GAL ◽

Marie PAQUET ◽

David CHARDIN ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Sensitivity And Specificity ◽

Cell Lung Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Tumor Response ◽

Small Cell ◽

Small Cell Lung ◽

18Fdg Pet

Abstract PurposeWe evaluated the prognostic value of immunotherapy-induced organ inflammation observed on 18FDG PET in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICPI).MethodsData from patients with IIIB/IV NSCLC included in two different prospective trials were analyzed. 18FDG PET/CT exams were performed at baseline (PETBaseline) and repeated after 7-8 weeks (PETInterim1) and 12-16 weeks (PETInterim2) of treatment, using iPERCIST for tumor response evaluation. The occurrence of abnormal organ 18FDG uptake, deemed to be due to ICPI-related organ inflammation, was collected.ResultsExploratory cohort (Nice, France): PETinterim1 and PETinterim2 revealed the occurrence of at least one ICPI-induced organ inflammation in 72.8% of patients, including: midgut/hindgut inflammation (33.7%), gastritis (21.7%), thyroiditis (18.5%), pneumonitis (17.4%), and other organ inflammations (9.8%). iPERCIST tumor response was associated with improved Progression Free Survival (p<0.001). iPERCIST tumor response and immuno-induced gastritis assessed on PET were both associated with improved Overall Survival (OS) (p<0.001 and p=0.032). Combining these two independent variables, we built a model predicting patients 2-year OS with a sensitivity of 80.3% and a specificity of 69.2% (AUC=72.7).Validation cohort (Genova, Italy): Immuno-induced gastritis (19.6% of patients) was associated with improved OS (p=0.04). The model built previously predicted 2-years OS with a sensitivity and specificity of 72.0% and 63.6% (AUC=70.7) and 3-years OS with a sensitivity and specificity of 69.2% and 80.0% (AUC= 78.2).ConclusionImmuno-induced gastritis revealed by early interim 18FDG PET in around 20% of patients with NSCLC treated with ICPI, is a novel and reproducible imaging biomarker of improved OS.

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