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  • Title: Feasibility study of FDG PET/CT-derived primary tumour glycolysis as a prognostic indicator of survival in patients with non-small-cell lung cancer.
    Author: Mehta G, Chander A, Huang C, Kelly M, Fielding P.
    Journal: Clin Radiol; 2014 Mar; 69(3):268-74. PubMed ID: 24315703.
    Abstract:
    AIM: To assess the feasibility and prognostic value of measuring total lesion glycolysis of the primary tumour (TLG(primary)) using combined 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) in patients with proven or suspected non-small-cell lung cancer (NSCLC) in the routine diagnostic setting. MATERIALS AND METHODS: At the All wales Research and Diagnostic Positron Emission Tomography Centre in Cardiff (PETIC), in the calendar year 2011, 288 consecutive patients were identified with a single pulmonary mass in whom NSCLC was confirmed or clinically diagnosed following multidisciplinary team review. In a retrospective analysis, for each patient the PET-derived volume of the primary tumour and SUVMEAN was calculated using adaptive thresholds of 40% and 50% of the SUVMAX of the primary tumour. The TLG(primary) (calculated by volume x SUVMEAN) was calculated at these two thresholds and was used to predict survival in a multivariate analysis with TNM (tumour, node, metastasis) stage, age, sex, and SUV(MAX). The primary endpoint was overall survival over a minimum follow-up of at least 7 months. RESULTS: In virtually every case, the primary tumour could be measured using the automated software with minimal use of manual adjustments. In multivariate analysis, TNM clinical stage, log(TLG(primary)) and sex were independent predictors of overall survival. CONCLUSION: Measurements of primary tumour total lesion glycolysis are simple to perform and provide additional prognostic information over and above that provided by TNM staging.
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