Behgam Shadmehr Mohammad, Khosravi Adnan, Abbasi Dezfouli Azizollah, Bakhshayesh-Karam Mehrdad, Jamaati Hamidreza, Doroudinia Abtin, Mohaghegh Seyedeh Marzieh, Mehrian Payam, Emami Habib, Dorudinia Atosa
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran-Iran.
Tanaffos. 2020 Jul;19(3):186-194.
An initial evaluation of non-small cell lung cancer (NSCLC) patients with 18F- fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan can modify treatment planning. We investigated the clinical significance of FDG PET/CT quantitative parameters (QPs) in NSCLC patients.
We included 125 NSCLC patients for initial staging FDG PET/CT scan. The primary tumor (T), regional lymph node metastases (N), and distant metastases (M) were evaluated on FDG PET/CT images. QPs, including standard uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated separately for each T, N, and M lesion and also for the whole body. Statistical analysis through SPSS version 22 was used to evaluate the clinical significance of PET/CT QPs concerning primary tumor pathology characteristics, initial tumor stage, and patient's prognosis.
We followed the patients for 19.28 (±11.42) months. Considering primary tumor pathology, there was a significant difference in FDG PET/CT QPs, including primary tumor SUVmax (p=0.00), metastases SUVmax (p=0.014), whole-body MTV (p=0.045), and whole-body TLG (p=0.002). There was also a significant difference in QPs, including primary tumor SUVmax (p=0.00) and regional lymph node metastases SUVmax (p=0.048) when accounting for tumor initial stage. There was a significant prognostic value for the whole-body TLG (p=0.01) and a cut-off point of 568 was reached to differentiate better versus worse survival outcome.
We demonstrated a statistically significant difference in FDG PET/CT QPs when accounting for primary NSCLC pathology characteristics and initial stage, as well as patient's prognosis, and recommend incorporating QP values into clinical PET/CT reports.
对非小细胞肺癌（NSCLC）患者进行18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）的初步评估可改变治疗方案。我们研究了FDG PET/CT定量参数（QPs）在NSCLC患者中的临床意义。
我们纳入了125例接受FDG PET/CT初始分期扫描的NSCLC患者。在FDG PET/CT图像上评估原发肿瘤（T）、区域淋巴结转移（N）和远处转移（M）。分别为每个T、N和M病变以及全身计算QPs，包括标准摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。使用SPSS 22版进行统计分析，以评估PET/CT QPs在原发肿瘤病理特征、初始肿瘤分期和患者预后方面的临床意义。
我们对患者进行了19.28（±11.42）个月的随访。考虑原发肿瘤病理，FDG PET/CT QPs存在显著差异，包括原发肿瘤SUVmax（p = 0.00）、转移灶SUVmax（p = 0.014）、全身MTV（p = 0.045）和全身TLG（p = 0.002）。在考虑肿瘤初始分期时，QPs也存在显著差异，包括原发肿瘤SUVmax（p = 0.00）和区域淋巴结转移灶SUVmax（p = 0.048）。全身TLG具有显著的预后价值（p = 0.01），区分生存结局较好与较差的临界值为568。
我们证明，在考虑原发性NSCLC病理特征、初始分期以及患者预后时，FDG PET/CT QPs存在统计学显著差异，并建议将QP值纳入临床PET/CT报告中。
