Department of Radiology, First Hospital of Lanzhou University, Lanzhou, Gansu, 730000, China.
Int J Comput Assist Radiol Surg. 2013 Mar;8(2):181-91. doi: 10.1007/s11548-012-0749-7. Epub 2012 May 30.
To determine whether whole-body metabolic tumor burden, measured as either metabolic tumor volume (MTVWB) or total lesion glycolysis (TLGWB), using FDG-PET/CT is an independent prognostic marker in non-small cell lung cancer (NSCLC).
328 patients with histologically proven NSCLC were identified for this retrospective analysis. This study was approved by our Institutional Review Board. All patients underwent baseline (18)F-FDG-PET/CT scan imaging before therapy. The MTVWB, TLGWB, maximum standardized uptake value (SUVmaxWB) and mean standardized uptake value (SUVmeanWB) of tumors throughout the whole body were measured from FDG-PET images with semi-automated 3D contouring software.
In univariate analysis, there was a statistically significant association of overall survival (OS) with the MTVWB (hazard ratio (HR) = 1.62, p < 0.001), TLGWB (HR = 1.47, p < 0.001). The patients with a MTVWB ≤ median of 65.7 ml and TLGWB ≤ median of 205.11 SUVmean * ml had a median OS of 41.1 and 35.4 months compared with 9.5 and 9.7 months for those with a MTVWB > 65.7 ml and TLGWB > 205.11 SUVmean * ml, respectively. From a series of multivariate Cox regression models, the MTVWB and TLGWB were significantly better than SUVmaxWB and SUVmeanWB at prognostication and significantly associated with patients' OS with HRs of 1.50 (p < 0.001) and 1.42 (p < 0.001), respectively, after adjustment for patient's age, gender and treatment intent as well as the tumor SUVmaxWB, histology and stage.
MTVWB and TLGWB as metabolic tumor burden measurements in (18)F-FDG-PET/CT are independent prognostic markers and are significantly better than SUVmaxWB and SUVmeanWB at prognostication.
确定使用 FDG-PET/CT 测量的全身代谢肿瘤负担（以代谢肿瘤体积（MTVWB）或总病变糖酵解（TLGWB）表示）是否为非小细胞肺癌（NSCLC）的独立预后标志物。
对 328 名经组织学证实的 NSCLC 患者进行了回顾性分析。本研究得到了我院机构审查委员会的批准。所有患者在治疗前均接受了基线（18）F-FDG-PET/CT 扫描成像。通过使用半自动 3D 轮廓软件，从 FDG-PET 图像中测量肿瘤在全身的 MTVWB、TLGWB、最大标准化摄取值（SUVmaxWB）和平均标准化摄取值（SUVmeanWB）。
在单因素分析中，总生存期（OS）与 MTVWB（危险比（HR）=1.62，p<0.001）、TLGWB（HR=1.47，p<0.001）呈显著相关。MTVWB 中位数≤65.7ml 和 TLGWB 中位数≤205.11SUVmeanml 的患者的中位 OS 分别为 41.1 和 35.4 个月，而 MTVWB>65.7ml 和 TLGWB>205.11SUVmeanml 的患者的中位 OS 分别为 9.5 和 9.7 个月。从一系列多变量 Cox 回归模型中，MTVWB 和 TLGWB 在预后方面明显优于 SUVmaxWB 和 SUVmeanWB，与患者的 OS 显著相关，HR 分别为 1.50（p<0.001）和 1.42（p<0.001），在调整患者年龄、性别和治疗意向以及肿瘤 SUVmaxWB、组织学和分期后。
（18）F-FDG-PET/CT 中代谢肿瘤负荷测量的 MTVWB 和 TLGWB 是独立的预后标志物，在预测方面明显优于 SUVmaxWB 和 SUVmeanWB。
