scholarly journals Prognostic and Predictive Values of Metabolic Parameters of 18F-FDG PET/CT in Patients With Non-Small Cell Lung Cancer Treated With Chemotherapy

2019 ◽  
Vol 18 ◽  
pp. 153601211984602 ◽  
Author(s):  
Xueyan Li ◽  
Dawei Wang ◽  
Lijuan Yu

Objectives: Increasing interests have been focused on using artificial intelligence (AI) to extend prognostic value of medical imaging. Feature extraction is a critical step for successful application of AI. The aim of this study was to explore several metabolic parameters measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) as potential AI features in predicting the effectiveness of chemotherapy in patients with non-small cell lung cancer (NSCLC). Methods: A set of metabolic parameters of PET/CT and clinical characteristics were detected from 137 patients with NSCLC treated with at least 1 cycle of chemotherapy. Survival receiver–operating characteristic (ROC) analysis was used to define the more significant parameters chosen for the following survival analysis. Patient survival was analyzed by Kaplan-Meier method, log-rank test, and Cox regression. Results: Survival ROC showed that maximum standardized uptake value (SUVmax), metabolic tumor volume 50% (MTV50), and total lesion glycolysis 50% (TLG50) had larger area under the curve, and the optimal cutoff values were 11.72, 4.04, and 34.55, respectively. Univariate and multivariate analyses synergistically showed that late PET/CT stage and MTV50 >4.04 were independent factors of poor survival in patients with NSCLC who received chemotherapy. Conclusions: Several potential prognostic biomarkers of PET/CT imaging have been extracted for predicting survival and selecting patients with NSCLC who are more likely to benefit from chemotherapy. The identification may accelerate the development of AI methods to improve treatment outcome for NSCLC.

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6096
Author(s):  
David Lang ◽  
Linda Ritzberger ◽  
Vanessa Rambousek ◽  
Andreas Horner ◽  
Romana Wass ◽  
...  

Quantitative biomarkers derived from positron-emission tomography/computed tomography (PET/CT) have been suggested as prognostic variables in immune-checkpoint inhibitor (ICI) treated non-small cell lung cancer (NSCLC). As such, data for first-line ICI therapy and especially for chemotherapy–ICI combinations are still scarce, we retrospectively evaluated baseline 18F-FDG-PET/CT of 85 consecutive patients receiving first-line pembrolizumab with chemotherapy (n = 70) or as monotherapy (n = 15). Maximum and mean standardized uptake value, total metabolic tumor volume (MTV), total lesion glycolysis, bone marrow-/and spleen to liver ratio (BLR/SLR) were calculated. Kaplan–Meier analyses and Cox regression models were used to assess progression-free/overall survival (PFS/OS) and their determinant variables. Median follow-up was 12 months (M; 95% confidence interval 10–14). Multivariate selection for PFS/OS revealed MTV as most relevant PET/CT biomarker (p < 0.001). Median PFS/OS were significantly longer in patients with MTV ≤ 70 mL vs. >70 mL (PFS: 10 M (4–16) vs. 4 M (3–5), p = 0.001; OS: not reached vs. 10 M (5–15), p = 0.004). Disease control rate was 81% vs. 53% for MTV ≤/> 70 mL (p = 0.007). BLR ≤ 1.06 vs. >1.06 was associated with better outcomes (PFS: 8 M (4–13) vs. 4 M (3–6), p = 0.034; OS: 19 M (12-/) vs. 6 M (4–12), p = 0.005). In patients with MTV > 70 mL, concomitant BLR ≤ 1.06 indicated a better prognosis. Higher MTV is associated with inferior PFS/OS in first-line ICI-treated NSCLC, with BLR allowing additional risk stratification.


Author(s):  
David Lang ◽  
Linda Ritzberger ◽  
Vanessa Rambousek ◽  
Andreas Horner ◽  
Romana Wass ◽  
...  

Quantitative biomarkers derived from positron-emission tomography/computed tomography (PET/CT) have been suggested as prognostic variables in immune-checkpoint inhibitor (ICI) treated non-small cell lung cancer (NSCLC). As such data for first-line ICI therapy and especially for chemotherapy-ICI combinations are still scarce, we retrospectively evaluated baseline 18F-FDG-PET/CT of 85 consecutive patients receiving first-line pembrolizumab with chemotherapy (n=70) or as monotherapy (n=15). Maximum and mean standardized uptake value, metabolic tumor volume (MTV), total lesion glycolysis and bone marrow-/ spleen to liver ratio (BLR/SLR) were calculated. Kaplan-Meier analyses and Cox-regression models were used to assess progression-free/overall survival (PFS/OS) and their determinant variables. Multivariate selection for PFS/OS revealed MTV as most relevant PET/CT biomarker (p&lt;0.001). Median PFS/OS were significantly longer in patients with MTV&le;70mL versus &gt;70mL (PFS: 10 months (M; 95% confidence interval 4-16) vs. 4M (3-5), p=0.001; OS: not reached vs. 10M (5-15), p=0.004). Disease control rate was 81% vs. 53% for MTV&le;/&gt;70mL (p=0.007). BLR &le;1.06 versus &gt;1.06 was associated with better outcomes (PFS: 8M (4-13) vs. 4M (3-6), p=0.034; OS: 19M (12-/) vs. 6M (4-12), p=0.005). In patients with MTV&gt;70mL, concomitant BLR&le;1.06 indicated a better prognosis. Higher MTV is associated with inferior PFS/OS in first-line ICI treated NSCLC, with BLR allowing additional risk stratification.


Lung Cancer ◽  
2021 ◽  
Vol 156 ◽  
pp. S3
Author(s):  
Daniel Hughes ◽  
Sarah Hunter ◽  
Daisuke Nonaka ◽  
Vicky Goh ◽  
Andrea Bille ◽  
...  

2020 ◽  
Author(s):  
Xiaoling Qiu ◽  
Hongge Liang ◽  
Wei Zhong ◽  
Jing Zhao ◽  
Minjiang Chen ◽  
...  

Abstract Background: Positron emission tomography/computed tomography (PET/CT) has been widely recognized for diagnosing and staging lung cancer, but the prognostic value of standardized uptake value (SUV) in patients with advanced non-small-cell lung cancer (NSCLC) remains controversial. We aim to explore whether fluorodeoxyglucose uptake has prognostic significance in patients with advanced NSCLC. Methods: We performed a retrospective analysis of the data of patients with advanced NSCLC who had undergone PET/CT before systemic treatment between June 2012 and June 2016. The relationship between the SUV of the pulmonary lesion and lesion size was evaluated via Spearman’s correlation analysis. We collected patients’ clinical and pathological data. Univariate and multivariate analyses were performed to analyze the factors influencing survival.Results: Altogether, 157 patients with advanced NSCLC were included. Among these, 135 died, 13 survived, and 9 had incomplete data (median follow-up period of 69 months). SUV was correlated with lesion size and was significantly greater for tumors ≥3 cm than for tumors <3 cm (10.2±5.4 vs. 5.6±3.3, t=-6.709, p=0.000). Univariate analysis showed that survival was associated with gender, tumor size, epidermal growth factor receptor (EGFR) gene mutation, SUV of the primary lung lesion, and treatment line. Multivariate analysis showed a significant correlation between SUV of the primary lung lesion and survival. The mortality risk of patients with SUV ≤6 was 35% lower than that of patients with SUV >6 (95% CI 0.436-0.972, Wald value 4.400, p=0.036). Conclusions: The SUV of the primary lung lesion on PET/CT is significantly correlated with survival in previously untreated patients newly diagnosed with advanced NSCLC.


Lung Cancer ◽  
2016 ◽  
Vol 93 ◽  
pp. 28-34 ◽  
Author(s):  
Simone Tönnies ◽  
Mario Tönnies ◽  
Jens Kollmeier ◽  
Torsten T. Bauer ◽  
Gregor J. Förster ◽  
...  

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