Jessica Margaret Davison BA, Presenter: Nothing to Disclose

Michael Thomas Andreoli BA, Abstract Co-Author: Nothing to Disclose

Gregory Russo MD, Abstract Co-Author: Nothing to Disclose

Gustavo Alberto Mercier MD, PhD, Abstract Co-Author: Consultant, Siemens AG

Michael Ebright MD, Abstract Co-Author: Nothing to Disclose

Rathan M Subramaniam MD, PhD, Abstract Co-Author: Research Grant, Siemens AG

The purpose of this study is to establish the value of MTV and TGA as prognostic imaging biomarkers for patient outcome (overall survival, OS) in NSCLC.

Thirty-nine patients with NSCLC who had an initial staging PET/CT between March 2007 and May 2009 were included in this retrospective study. MTV and TGA were measured using the gradient based PET Edge and 38%, 50% and 60% SUVmax threshold segmentation methods. Receiver operating characteristic (ROC) analysis was used to determine the cut-off value for comparison based on optimal sensitivity and specificity. Kaplan Meier curves were generated and compared using the Mantel Cox log rank test.

Thirty-nine patients (18 female 21 male) were included, mean age 67.6 (±10.6) years (10 stage I, 6 stage II, 16 stage III, and 7 stage IV). Mean follow up time was 16.9(±11.4) months. Twenty patients (51%) were dead and nineteen patients (49%) were alive at end of follow-up. The areas under the ROC curve (AUC) for MTV segmented by PET Edge, 38%, 50% and 60% SUVmax were 0.68 (95%CI 0.51-0.85; P=0.06), 0.63 (95%CI 0.45-0.81; P=0.16),0.63 (95%CI 0.45-0.81; P=0.17), 0.62 (95%CI 0.44-0.80; P=0.19), respectively. The AUC for TGA segmented by PET Edge and the same levels of SUVmax thresholds were 0.69 (95%CI 0.52-0.86; P=0.04), 0.66 (95%CI 0.48-0.83;P=0.10), 0.66 (95%CI 0.48-0.83; P=0.09), and 0.65 (95%CI 0.48-0.83; P=0.10). Kaplan Meir Survival Curves demonstrated significant difference in OS between patients with values above and below the optimum thresholds determined by ROC for PET Edge MTV and for TGA by all segmentation methods. The optimum PET Edge MTV cut-off was 7.00 ml (HR 3.35; 95%CI 1.05-6.85; P=0.039) and the optimum PET Edge TGA cut-off was 43g (HR 4.50; 95%CI 1.39-8.73; P=0.008).

Gradient based MTV and TGA are prognostic biomarkers for overall survival outcome in patients with NSCLC.

MTV and TGA of NSCLC may be used in assessing the outcome of patients and influence therapy in the future

Davison, J, Andreoli, M, Russo, G, Mercier, G, Ebright, M, Subramaniam, R, Metabolic Tumor Volume (MTV) and Total Glycolytic Activity (TGA) of FDG PET/CT as Prognostic Imaging Biomarkers in Non-Small Cell Lung Cancer (NSCLC).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11006861.html