Prognostic value of metabolic tumor volume on [18F]FDG PET/CT in addition to the TNM classification system of locally advanced non-small cell lung cancer

作者：Alexander Brose, Isabelle Miederer, J. König, Eleni Gkika, Jörg Sahlmann, Tanja Schimek‐Jasch, Mathias Schreckenberger, Ursula Nestle, Jutta Kappes, Matthias Miederer · 发表于：Cancer Imaging · 年份：2024 · DOI：10.1186/s40644-024-00811-7 · 被引用次数：11 · 研究领域：Lung Cancer Diagnosis and Treatment、Medical Imaging Techniques and Applications、Radiomics and Machine Learning in Medical Imaging

PURPOSE: F]FDG PET/CT, in particular to exclude distant metastases and guide local therapy approaches like resection and radiotherapy. Although it is hoped that PET/CT will increase the value of primary staging compared to conventional imaging, it is generally limited to the characterization of TNM. The first aim of this study was to evaluate the PET parameter metabolic tumor volume (MTV) above liver background uptake as a prognostic marker in lung cancer. The second aim was to investigate the possibility of incorporating MTV into the TNM classification system for disease prognosis in locally advanced NSCLC treated with chemoradiotherapy. METHODS: Retrospective evaluation of 235 patients with histologically proven, locally advanced NSCLC from the multi-centre randomized clinical PETPLAN trial and a clinical cohort from a hospital registry. The PET parameters SUVmax, SULpeak, MTV and TLG above liver background uptake were determined. Kaplan-Meier curves and stratified Cox proportional hazard regression models were used to investigate the prognostic value of PET parameters and TNM along with clinical variables. Subgroup analyses were performed to compare hazard ratios according to TNM, MTV, and the two variables combined. RESULTS: In the multivariable Cox regression analysis, MTV was associated with significantly worse overall survival independent of stage and other prognostic variables. In locally advanced disease stages treated with chemoradiotherapy, higher MTV was significa...