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. 2013 Jul 30;47(3):219-23.
doi: 10.2478/raon-2013-0023. eCollection 2013.

Prediction of 2 years-survival in patients with stage I and II non-small cell lung cancer utilizing (18)F-FDG PET/CT SUV quantification

Angelina Cistaro  1 , Natale Quartuccio, Alireza Mojtahedi, Piercarlo Fania, Pier Luigi Filosso, Alfredo Campenni, Umberto Ficola, Sergio Baldari
Affiliations

Prediction of 2 years-survival in patients with stage I and II non-small cell lung cancer utilizing (18)F-FDG PET/CT SUV quantification

Angelina Cistaro et al. Radiol Oncol. .

Abstract

Background: The purpose of the study was to evaluate the correlation between the maximum standardized uptake value (SUVmax), size of primary lung lesion, disease-free survival (DFS) and overall survival (OS) in patients with stage I and II non-small cell lung cancer (NSCLC) in 2 years follow-up.

Patients and methods: Forty-nine patients with stage I-II NSCLC were included in this study. Pre-surgical 2-deoxy-2-[18F]fluoro-D-glucose positron-emission tomography ((18)F-FDG PET/CT) study was performed for all patients. The relationship between SUVmax, tumour size and clinical outcome was measured. The cut-off value for SUVmax and tumour size with the best prognostic significance, probability of DFS and the correlation between SUVmax and the response to therapy were calculated.

Results: There was a statistically significant correlation between SUVmax and DFS (p = 0.029). The optimal cut-offs were 9.00 for SUVmax (p = 0.0013) and 30mm for tumour size (p = 0.0028). Patients with SUVmax > 9 and primary lesion size > 30 mm had an expected 2years-DFS of 37.5%, while this rose to 90% if the tumour was <30 mm and/or SUVmax was <9.

Conclusions: In stage I-II, SUVmax and tumour size might be helpful to identify the subgroup of patients with high chance for recurrence.

Keywords: 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography; disease-free survival; maximum standardized uptake value; non-small cell lung cancer; overall survival.

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Figures

FIGURE 1.
FIGURE 1.
Disease-free survival (DFS) curves (Kaplan-Meier) based on a dimensional cut-off of 30 mm. The disease-free survival curves illustrate that patients with a lung cancer with dimension < 30 mm present a better prognosis (significant longer DFS) than patients with lung cancer size > 30 mm. Dashed line = DFS for patients in stage I–II with lesion diameter < 30 mm. Continuous line = DFS for patients in stage I–II with lesion diameter > 30 mm.
FIGURE 2.
FIGURE 2.
Disease-free survival (DFS) curves (Kaplan-Meier) based on a cut-off maximum standardized uptake value (SUVmax) of nine. The disease-free survival curves illustrate that patients with lung cancer SUVmax < 9 present a significant longer DFS than patients with lung cancer SUVmax > 9. Dashed line = DFS for patients in stage I–II with SUVmax < 9; Continuous line = DFS for patients in stage I–II with SUVmax > 9.
FIGURE 3A.
FIGURE 3A.
Pre-surgical 18F-FDG PET/CT axial images. Abnormal 18F-FDG uptake (SUVmax < 9) in a cancer lesion located in the perihilar region of the right lung (size < 30 mm).
FIGURE 3B.
FIGURE 3B.
Post-surgical 18F-FDG PET/CT axial images. No pathological 18F-FDG uptake can be detected in the perihilar region of the right lung.
See this image and copyright information in PMC

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