Chenpeng Zhang MD, PhD, Presenter: Nothing to Disclose

Cassie A Simon, Abstract Co-Author: Nothing to Disclose

Daniel Eric Appelbaum MD, Abstract Co-Author: Nothing to Disclose

Yonglin Pu MD, PhD, Abstract Co-Author: Researcher, Eli Lilly and Company Researcher, General Electric Company

The prognostic value of whole-body metabolic tumor burden (MTBWB) in NSCLC measured as either metabolic tumor volume (MTVWB) or total lesion glycolysis (TLGWB) in the body on baseline FDG PET/CT has been established. However, the prognostic value of MTBWB after surgery has not been reported in the literature. This study aims to evaluate the prognostic value of (MTBWB) in post-surgical FDG-PET/CT scans of the patients.

147 patients (73 females and 74 males with mean age of 66.9 years) with histologically proven NSCLC were selected for this IRB approved retrospective study. All patients underwent surgery for curative purpose and post-surgical 18F-FDG-PET/CT scans. Seventy-three patients had died (49.7%) during follow-up. Median follow-up time among survivors was 18.32 months. The MTVWB, TLGWB and SUVmaxWB) of tumors in the whole body were measured from FDG-PET images with semi-automated 3D contouring software. Cox regression for survival analysis was undertaken using clinical, pathological and PET imaging variables. Overall survival (OS) served as the primary endpoint of the study, calculated from the date of the post-surgical PET/CT scan to the date the patients died from any cause.

The mean (SD), median and range of the MTVWB, TLGWB and SUVmaxWB of tumors was 73.0(183.4), 12.9 and 0-1696.3 ml; 324.3(792.1), 37.5, and 0-5584.8 ml x SUV; and 7.0(7.4), 5.2, and 0-34.1 respectively. In univariate analysis, there was a statistically significant association of OS with the MTVWB (hazard ratio (HR) = 1.002；p<0.001), TLGWB (HR = 1.001；p<0.001). Four groups of the patients (MTVWB= 0 ml, MTVWB > 0 ml and <13.44 ml, MTVWB ≥13.44ml and <60.14ml, MTVWB ≥ 60.14 ml) had mean OS of 65.7, 43.7, 34.5, and 13.9 months, respectively. On multivariate Cox regression models, both MTVWB and TLGWB were significantly associated with the patient’s OS independent of the patient’s age, gender, tumor histology, SUVmaxWB, TNM re-stage and surgical procedures. The HRs were 1.002 (p<0.001) and 1.001 (p< 0.001) for MTVWB and TLGWB, respectively.

MTVWB and TLGWB as metabolic tumor burden measurements in post-surgical 18F-FDG-PET/CT are independent prognostic markers.

The metabolic tumor burden measurement on post-surgical PET/CT scans can help clinicians to estimate the patient’s prognosis and may help them determine further treatment for the patients with non-small cell lung cancer.

Zhang, C, Simon, C, Appelbaum, D, Pu, Y, Prognostic Value of Whole-body Metabolic Tumor Burden on Post-surgical FDG-PET Imaging for Non-small Cell Lung Cancer Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045707.html