Prognostic and Predictive Values of F-18 FDG PET/CT Volumetric Parameters in Small Cell Lung Cancer

Year 2024, , 1 - 12, 14.01.2025

Esra Arslan , Göksel Alçın , Tamer Aksoy , Ozlem Mermut , Sedat Altin

https://doi.org/10.71286/moi.1582606

Abstract

Introduction: Volumetric parameters of the 18F-FDG PET/CT can contribute to the treatment decision in high risk patients. In the present study, we aimed to examine the predictive, prognostic, and clinical value of PET/CT by using the two volumetric parameters: metabolic tumor volume (MTV) and total lesion glycolysis (TLG), SUVmax to concurrently evaluate survival data in patients diagnosed with small cell lung cancer (SCLC).
Methods: 244 patients with SCLC, who underwent 18F-FDG PET/CT imaging for staging purpose were enrolled. Primary tumor SUVmax, MTV (40-70%) and TLG (40-70%) obtained from PET/CT were documented.
Results: All lesions (n=244) showed 18F-FDG uptake, mean SUVmax of 19.74±8.71 [range (min – max) = 3.80 - 58.80]. SUVmax was significantly higher in tumors with diameters > 2 cm compared to those with diameters ≤ 2 cm (p=0.000). The mean survival time was significantly shorter in patients with tumor diameter greater than 2 cm, locoregional LN involvement, distant nodal metastasis, or distant organ metastasis (p=0.019, p<0.001, p<0.001 and p<0.001, respectively). Primary tumor SUVmax showed statistically significant positive correlation with tumor size, TLG40/70, and SUVmean40/70. Also, high MTV40 and TLG40 showed statistically significant association with increased tumor diameter and distant organ metastasis.
Conclusion: In our study, volumetric parameters of 18F-FDG PET/CT showed remarkable superiority specifically over metabolic parameters in the detection of distant organ metastasis. Patients with high FDG uptake in primary tumors should be carefully evaluated for poor prognostic and metastatic potential; optimal treatment should be planned accordingly.

Keywords

Volumetric parameters, 18F-FDG PET/CT, Small Cell lung cancer

Ethical Statement

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