We evaluated the prognostic significance of standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on [F-18]FDG PET/CT in patients with non-surgical non-small-cell lung cancer (NSCLC).
103 patients (mean age, 65,6±16 years) underwent [F-18]FDG PET/CT before the chemotherapy. The SUVmax value, the MTV (cm3; 42% threshold) and the TLG (g) were registered. The patients were followed up 18 months thereafter (range 12-55 months). Main events such as failure to respond without progression, progression and/or disease-related death constituted surrogate end-points. The optimal SUVmax, MTV and TLG cut-off to predict the patients’ outcome was estimated. PET/CT results were then related to disease outcome (progression free survival; PFS).
The Kaplan-Meier survival analysis for SUVmax showed a significant better PFS in patients presenting lower values as compared to those having higher (p <0.05, log-rank test). MTV and TLG were not suitable for predicting PFS apart from the subset with mediastinal nodal involvement.
Despite the availability of new tools for the quantitative assessment of disease activity on PET/CT the SUVmax rather than MTV and TLG remains the only predictor for PFS in NSCLC patients. MTV holds a value only when concomitant nodal involvement occurs.