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KMID : 1148920180520010031
Nuclear Medicine and Molecular Imaging
2018 Volume.52 No. 1 p.31 ~ p.38
Prognostic Value of Pre- and Post-Treatment FDG PET/CT Parameters in Small Cell Lung Cancer Patients
Kim Hyoung-Woo

Yoo Ie-Ryung
Boo Sun-Ha
Park Hye-Lim
O Joo-Hyun
Abstract
Purpose: To evaluate the prognostic value of PET parameters obtained from pre- and post-treatment FDG PET/CT examinations in patients with SCLC.

Methods: Fifty-nine patients with initially diagnosed SCLC from 2009 to 2014 were included and had chemotherapy and/or concurrent chemoradiotherapy. FDG PET/CT examinations were performed before (PET1) and after (PET2) treatment to evaluate treatment response. A region of interest was placed over the primary lesion and metastatic lymph nodes within the thoracic cavity. PET parameters including change from PET1 to PET2 (¥Ä in %) were acquired: SUVmax, SUVpeak, MTV2.5, TLG, ¥ÄSUVmax, ¥ÄSUVpeak, ¥ÄMTV and ¥ÄTLG. Patient characteristics including staging, age, sex, LDH and response evaluation by RECIST were surveyed. Statistical analysis was done using Kaplan-Meier method and Cox regression analysis with respect to OS and PFS.

Results: The median follow-up was 9.6 months (2.5?80.5 months). 27 patients were LD and 32 were ED. Forty-six patients (78.0%) had died, and median OS was 8.6 months; 51 patients (86%) showed disease progression, and median PFS was 2.5 months. On univariate analysis, patients with ED, high interval change (¥ÄSUVmax and ¥ÄSUVpeak) and low PET2 parameters showed longer OS and PFS. Multivariate analyses demonstrated that ¥ÄSUVpeak (HR 2.6, P = 0.002) was an independent prognostic factors for OS, and MTV2.5 of PET2 (HR 2.8, P = 0.001), disease stage (HR 2.7, P = 0.003) and RECIST (HR 2.0, P = 0.023) were independent prognostic factors for PFS.

Conclusions: Metabolic and volumetric PET parameters obtained from pre- and post-treatment FDG PET/CT examinations in patients with SCLC have significant prognostic information.
KEYWORD
FDG PET/CT, Small-cell lung cancer, Prognosis, SUVpeak, Treatment response
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