Ratio of standardized uptake value on PET helps predict response and outcome after chemotherapy in advanced non-small cell lung cancer

• Published in: Annals of nuclear medicine Vol. 24; no. 10; pp. 697 - 705
• Main Authors: Kaira, Kyoichi, Endo, Masahiro, Asakura, Koiku, Tsuya, Asuka, Nakamura, Yukiko, Naito, Tateaki, Murakami, Haruyasu, Takahashi, Toshiaki, Yamamoto, Nobuyuki
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.12.2010; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biological Transport; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - metabolism; Carcinoma, Non-Small-Cell Lung - pathology; Female; Fluorodeoxyglucose F18 - metabolism; Humans; Imaging; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplasm Metastasis; Neoplasm Staging; Nuclear Medicine; Original Article; Positron-Emission Tomography - methods; Positron-Emission Tomography - standards; Radiology; Retrospective Studies; Survival Rate; Treatment Outcome; F-FDG PET; Ratio of SUV; Chemotherapy; Advanced; NSCLC
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-010-0412-8

Background The maximum standardized uptake value (SUV max ) on 18 F-fluorodeoxyglucose-positron emission tomography ( 18 F-FDG PET) within the primary tumor may predict outcome in patients with surgically resected non-small cell lung cancer (NSCLC). However, it remains uncertain whether the SUV max of the primary tumor predicts outcome after chemotherapy in advanced NSCLC. Thus, we evaluated the ratio of SUV max of the metastatic tumor to the primary tumor ( M / P ratio) to determine whether it could be a useful marker in predicting response and outcome after chemotherapy in advanced NSCLC. Methods Chemo-naïve patients with advanced NSCLC who had locoregional lymph nodes and/or distant metastases other than brain, were eligible for inclusion in this study. Response and survival were analyzed according to the SUV max of primary tumor, the ratio of the SUV max of the tumor to the mean SUV of the mediastinum ( T / M ratio) and M / P ratio. Results One hundred and four consecutive patients were included in the retrospective study. Patients with high M / P ratio exhibited significantly lower response rates. The value of SUV max and T / M ratio were not associated with the response to initial chemotherapy. In the univariate analysis, T / M ratio and SUV max were significantly associated with poor outcome. However, the outcome of non-adenocarcinoma was unaffected by T / M ratio and SUV max . Multivariate analysis confirmed that high M / P ratio was a significant independent factor predicting a poor outcome. Conclusion High M / P ratio was associated with a poor response to initial chemotherapy and was a significant independent factor in predicting poor outcome in advanced NSCLC patients with metastatic tumors other than in brain.