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Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC.
- Source :
-
Nuklearmedizin. Nuclear medicine [Nuklearmedizin] 2023 Oct; Vol. 62 (5), pp. 284-292. Date of Electronic Publication: 2023 Sep 11. - Publication Year :
- 2023
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Abstract
- Aim: The aim of this study was to derive prognostic parameters from 2-[ <superscript>18</superscript> F]fluoro-2-deoxy-D-glucose ([ <superscript>18</superscript> F]FDG-PET/CT) in patients with low-risk NSCLC and determine their prognostic value.<br />Methods: 81 (21 female, mean age 66 a) therapy-naive patients that underwent [18F]FDG-PET/CT before histologic confirmation of NSCLC with stadium I and II between 2008-2016 were included. A mean follow-up time of 58 months (13-176), overall and progression free survival (OS, PFS) were registered. A volume of interest for the primary tumor was defined on PET and CT images. Parameters SUV <subscript>max</subscript> , PET-solidity, PET-circularity, and CT-volume were analyzed. To evaluate the prognostic value of each parameter for OS, a minimum p-value approach was used to define cutoff values, survival analysis, and log-rank tests were performed, including subgroup analysis for combinations of parameters.<br />Results: Mean OS was 58±28 months. Poor OS was associated with a tumor CT-volume >14.3 cm <superscript>3</superscript> (p=0.02, HR=7.0, CI 2.7-17.7), higher SUV <subscript>max</subscript> values >12.2 (p=0.003; HR=3.0, CI 1.3-6.7) and PET-solidity >0.919 (p=0.004; HR=3.0, CI 1.0-8.9). Combined parameter analysis revealed worse prognosis in larger volume/high SUV <subscript>max</subscript> tumors compared to larger volume/lower SUV <subscript>max</subscript> (p=0.028; HR=2.5, CI 1.1-5.5), high PET-solidity/low volume (p=0.01; HR=2.4, CI 0.8-6.6) and low SUV <subscript>max</subscript> /high PET-solidity (p=0.02, HR=4.0, CI 0.8-19.0).<br />Conclusion: Even in this group of low-risk NSCLC patients, we identified a subgroup with a significantly worse prognosis by combining morphologic-metabolic biomarkers from [18F]FDG-PET/CT. The combination of SUV <subscript>max</subscript> and CT-volume performed best. Based on these preliminary data, future prospective studies to validate this combined morphologic-metabolic imaging biomarker for potential therapeutic decisions seem promising.<br />Competing Interests: Beer AJ: AAA GmbH - Honorar Vortragstätigkeit Advisory Board Meeting Janssen-Cilag - Honorar Vortragstätigkeit VSRN Baden-Baden über KelCon - Honorar Vortragstätigkeit AAA GmbH - Honorar Vortragstätigkeit Fa. NVision Imaging Technologies GmbH Ulm - Mitglied Scientific Advisory Board - Ärztlicher Direktor Klinik für Nuklearmedizin, Universitätsklinikum Ulm - Präsident Südwestdeutsche Gesellschaft für Nuklearmedizin SWDGN - Forschungskooperation PET/MRT mit Siemens Healthcare GmbH Erlangen<br /> (Thieme. All rights reserved.)
- Subjects :
- Humans
Female
Aged
Prognosis
Positron Emission Tomography Computed Tomography
Fluorodeoxyglucose F18 therapeutic use
Prospective Studies
Biomarkers
Retrospective Studies
Tumor Burden
Carcinoma, Non-Small-Cell Lung diagnostic imaging
Carcinoma, Non-Small-Cell Lung pathology
Lung Neoplasms diagnostic imaging
Lung Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 2567-6407
- Volume :
- 62
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Nuklearmedizin. Nuclear medicine
- Publication Type :
- Academic Journal
- Accession number :
- 37696296
- Full Text :
- https://doi.org/10.1055/a-2150-4130