Standardized Uptake Value on <sup>18</sup>F-FDG PET/CT as a Prognostic Factor for Survival of Women with Malignant Uterine Tumors: A Meta-Analysis

Background 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) has been widely used in clinical practice. However, the prognostic value of the pre-treatment standardized uptake value (SUV) for patients with small-cell lung cancer (SCLC) remains controversial. Purpose To investigate the prognostic role of pre-treatment 18F-FDG PET on SCLC patients by meta-analysis. Material and Methods Extensive literature searches of the PubMed, EMBASE, Web of Science, and Cochrane Library databases were conducted to identify literature published until 5 May 2017. Comparative analyses of the pooled hazard ratios (HRs) for event-free survival (EFS) and overall survival (OS) were performed to assess their correlations with the pre-treatment maximum SUV (SUVmax). Either the fixed- or the random-effects model was adopted, depending on the heterogeneity observed across the studies. Subgroup analyses were performed to assess the robustness of the results. Results Twelve studies with 1062 patients were included. The pooled HR for OS of 11 studies was 1.13 (95% confidence interval [CI] = 1.05–1.22; P = 0.001; I2 = 0%) and the pooled HR for EFS of nine studies was 1.09 (95% CI = 1.02–1.17; P = 0.014; I2 = 0%), indicating that patients with high SUVs may have poorer prognoses. Begg’s test detected no significant publication bias. The prognostic role of the SUVmax remained similar in the subgroup analyses. Conclusion Our meta-analysis indicated that the pre-treatment SUVmax of primary lesions can be an important prognostic factor for OS and EFS in patients with SCLC. A high SUVmax may indicate poorer prognosis.

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Prognostic Value of Lymph Node to Primary Tumor Standardized Uptake Value Ratio in Unresectable Esophageal Cancer

10.21203/rs.3.rs-25249/v1 ◽

2020 ◽

Author(s):

Po-Jui Chen ◽

Wing-Keen Yap ◽

Yu-Chuan Chang ◽

Chen-Kan Tseng ◽

Yin-Kai Chao ◽

...

Keyword(s):

Esophageal Cancer ◽

Prognostic Factor ◽

Treatment Outcomes ◽

Distant Metastasis ◽

Primary Tumor ◽

Fdg Pet ◽

Roc Analysis ◽

Standardized Uptake Value ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Background Unresectable esophageal cancer harbors high mortality despite chemoradiotherapy. Better patient selection for more personalized management may result in better treatment outcomes. We presume the ratio of maximum standardized uptake value (SUV) of metastatic lymph nodes to primary tumor (NTR) in 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) may provide prognostic information and further stratiﬁcation of these patients. Methods The patients with non-metastatic and unresectable esophageal squamous cell carcinoma (SCC) receiving FDG PET/CT staging and treated by chemoradiotherapy were retrospectively reviewed. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off value for NTR. Kaplan-Meier method and Cox regression model were used for survival analyses and multivariable analyses, respectively.Results From 2010 to 2016, 96 eligible patients were analyzed. The median follow-up time was 10.2 months (range 1.6 to 83.6 months). Using ROC analysis, the best NTR cut-off value was 0.46 for prediction of distant metastasis. The median distant metastasis-free survival (DMFS) was significantly lower in the high-NTR group (9.5 vs. 22.2 months, p = 0.002) and median overall survival (OS) (9.5 vs. 11.6 months, p = 0.013) was also signiﬁcantly worse. Multivariable analysis revealed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR] 1.81, p = 0.023) and OS (HR 1.77, p = 0.014).Conclusions High pretreatment NTR predicts worse treatment outcomes and could be an easy-to-use and helpful prognostic factor to provide more personalized treatment for patients with non-metastatic and unresectable esophageal SCC.

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The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review

Annals of Nuclear Medicine ◽

10.1007/s12149-021-01629-0 ◽

2021 ◽

Author(s):

Laura Evangelista ◽

Pietro Zucchetta ◽

Lucia Moletta ◽

Simone Serafini ◽

Gianluca Cassarino ◽

...

Keyword(s):

Neoadjuvant Therapy ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Response To Therapy ◽

Ductal Adenocarcinoma ◽

Resectable Pancreatic Cancer ◽

Number Of Patients ◽

Pet Ct ◽

Fdg Pet Ct

AbstractThe aim of the present systematic review is to examine the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) associated with computed tomography (CT) or magnetic resonance imaging (MRI) in assessing response to preoperative chemotherapy or chemoradiotherapy (CRT) for patients with borderline and resectable pancreatic ductal adenocarcinoma (PDAC). Three researchers ran a database query in PubMed, Web of Science and EMBASE. The total number of patients considered was 488. The most often used parameters of response to therapy were the reductions in the maximum standardized uptake value (SUVmax) or the peak standardized uptake lean mass (SULpeak). Patients whose SUVs were higher at the baseline (before CRT) were associated with a better response to therapy and a better overall survival. SUVs remaining high after neoadjuvant therapy correlated with a poor prognosis. Available data indicate that FDG PET/CT or PET/MRI can be useful for predicting and assessing response to CRT in patients with resectable or borderline PDAC.

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Role of 18F-PET-CT to predict pathological response after neoadjuvant treatment of rectal cancer

Discover Oncology ◽

10.1007/s12672-021-00405-w ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Riccardo Caruso ◽

Emilio Vicente ◽

Yolanda Quijano ◽

Hipolito Duran ◽

Isabel Fabra ◽

...

Keyword(s):

Rectal Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Standardized Uptake Value ◽

Tumour Regression Grade ◽

Pet Ct ◽

Significant Difference ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.

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Splenic uptake on FDG PET/CT correlates with Kikuchi-Fujimoto disease severity

Scientific Reports ◽

10.1038/s41598-021-90350-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hye Seong ◽

Yong Hyu Jeong ◽

Woon Ji Lee ◽

Jun Hyoung Kim ◽

Jung Ho Kim ◽

...

Keyword(s):

Disease Severity ◽

Fdg Pet ◽

Tertiary Care ◽

Clinical Manifestations ◽

Standardized Uptake Value ◽

Total Lesion Glycolysis ◽

Positron Emission ◽

Pet Ct ◽

Systemic Symptoms ◽

Fdg Pet Ct

AbstractKikuchi-Fujimoto disease (KFD) is usually self-limiting, but prolonged systemic symptoms often result in frequent hospital visits, long admission durations, or missed workdays. We investigated the role of fluorine-18 fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing KFD severity. We reviewed the records of 31 adult patients with pathologically confirmed KFD who underwent 18F-FDG PET/CT between November 2007 and April 2018 at a tertiary-care referral hospital. Disease severity was assessed using criteria based on clinical manifestations of advanced KFD. Systemic activated lymph nodes and severity of splenic activation were determined using semi-quantitative and volumetric PET/CT parameters. The median of the mean splenic standardized uptake value (SUVmean) was higher in patients with severe KFD than those with mild KFD (2.38 ± 1.18 vs. 1.79 ± 0.99, p = 0.058). Patients with severe KFD had more systemically activated volume and glycolytic activity than those with mild KFD (total lesion glycolysis: 473.5 ± 504.4 vs. 201.6 ± 363.5, p = 0.024). Multivariate logistic regression showed that myalgia (odds ratio [OR] 0.035; 95% confidence interval [CI] 0.001–0.792; p = 0.035), total lymph node SUVmax (cutoff 9.27; OR 24.734; 95% CI 1.323–462.407; p = 0.032), and spleen SUVmean (cutoff 1.79; OR 37.770; 95% CI 1.769–806.583; p = 0.020) were significantly associated with severe KFD. 18F-FDG PET/CT could be useful in assessing KFD severity.

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18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

European Journal of Hybrid Imaging ◽

10.1186/s41824-020-00091-x ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Alaa Mouminah ◽

Austin J. Borja ◽

Emily C. Hancin ◽

Yu Cheng Chang ◽

Thomas J. Werner ◽

...

Keyword(s):

Parotid Gland ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Post Treatment ◽

Parotid Glands ◽

Positron Emission ◽

Pet Ct ◽

Average Maximum ◽

Pre Treatment ◽

Fdg Pet Ct

Abstract Background 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC). Methods This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT. Results Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT. Conclusion Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

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Relationship between tumor mutational burden and maximum standardized uptake value in 2-[18F]FDG PET (positron emission tomography) scan in cancer patients

EJNMMI Research ◽

10.1186/s13550-020-00732-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Amin Haghighat Jahromi ◽

Donald A. Barkauskas ◽

Matthew Zabel ◽

Aaron M. Goodman ◽

Garret Frampton ◽

...

Keyword(s):

Fdg Pet ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Maximum Standardized Uptake Value ◽

Tissue Biopsy ◽

Mutational Burden ◽

Positron Emission ◽

Pet Ct ◽

Tumor Mutational Burden ◽

Fdg Pet Ct

Abstract Purpose Deriving links between imaging and genomic markers is an evolving field. 2-[18F]FDG PET/CT (18F-fluorodeoxyglucose positron emission tomography–computed tomography) is commonly used for cancer imaging, with maximum standardized uptake value (SUVmax) as the main quantitative parameter. Tumor mutational burden (TMB), the quantitative variable obtained using next-generation sequencing on a tissue biopsy sample, is a putative immunotherapy response predictor. We report the relationship between TMB and SUVmax, linking these two important parameters. Methods In this pilot study, we analyzed 1923 patients with diverse cancers and available TMB values. Overall, 273 patients met our eligibility criteria in that they had no systemic treatment prior to imaging/biopsy, and also had 2-[18F]FDG PET/CT within 6 months prior to the tissue biopsy, to ensure acceptable temporal correlation between imaging and genomic evaluation. Results We found a linear correlation between TMB and SUVmax (p < 0.001). In the multivariate analysis, only TMB independently correlated with SUVmax, whereas age, gender, and tumor organ did not. Conclusion Our observations link SUVmax in readily available, routinely used, and noninvasive 2-[18F]FDG PET/CT imaging to the TMB, which requires a tissue biopsy and time to process. Since higher TMB has been implicated as a prognostic biomarker for better outcomes after immunotherapy, further investigation will be needed to determine if SUVmax can stratify patient response to immunotherapy.

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