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KMID : 1148920140480010016
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Nuclear Medicine and Molecular Imaging
2014 Volume.48 No. 1 p.16 ~ p.25
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Intratumoral Metabolic Heterogeneity for Prediction of Disease Progression After Concurrent Chemoradiotherapy in Patients with Inoperable Stage III Non-Small-Cell Lung Cancer
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Kang Sae-Ryung
Song Ho-Chun
Byun Byung-Hyun
Oh Jong-Ryool
Kim Hyeon-Sik
Hong Sun-Pyo
Kwon Seong-Young
Chong A-Ri
Kim Ja-Hae
Cho Sang-Geon
Park Hee-Jeong
Kim Young-Chul
Ahn Sung-Ja
Min Jung-Joon
Bom Hee-Seung
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Abstract
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Purpose: We evaluated the value of variable 18F-FDG PET/CT parameters for the prediction of disease progression after concurrent chemoradiotherapy (CCRT) in patients with inoperable stage III non-small-cell lung cancer (NSCLC).
Methods: One hundred sixteen pretreatment FDG PET/CT scans of inoperable stage III NSCLC were retrospectively reviewed (stage IIIA: 51; stage IIIB: 65). The volume of interest was automatically drawn for each primary lung tumor, and PET parameters were assessed as follows: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) using the boundaries presenting SUV intensity exceeding 3.0, and the area under the curve of the cumulative SUV-volume histograms (AUC-CSH), which is known to reflect the tumor heterogeneity. Progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared with each PET and clinical parameters by univariate and multivariate survival analysis.
Results: In the ROC analysis, the optimal cutoff values of SUVmax, MTV (cm3), and AUC-CSH for prediction of PFS were determined as 21.5, 27.7, and 4,800, respectively. In univariate analysis, PFS was statistically significantly reduced in those with AUC-CSH?
Conclusions: Intratumoral metabolic heterogeneity of primary lung tumor in 18F-FDG PET/CT can predict disease progression after CCRT in inoperable stage III NSCLC.
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KEYWORD
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Non-small-cell lung cancer, Intratumoral heterogeneity, Prognosis, F-18 FDG PET
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