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Nuklearmedizin 2023; 62(05): 284-292
DOI: 10.1055/a-2150-4130
Original Article

Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC

Kombinierte morphologisch-metabolische Biomarker der [18F]FDG-PET/CT stratifiziert nach Prognosegruppen in Low-risk-NSCLC-Patienten
Katharina Deininger
1   Nuclear Medicine, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
,
Joel Niclas Raacke
1   Nuclear Medicine, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
2   Urology, Clinical Centre St. Elisabethen, Ravensburg, Germany
,
Elham Yousefzadeh-Nowshahr
3   Nuclear Medicine Medical Radiation Physics, Ulm University, Ulm, Germany (Ringgold ID: RIN9189)
,
Cornelia Kropf-Sanchen
4   Internal Medicine II, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
,
Bernd Muehling
5   Cardiac and Thoracic Surgery, Section Thoracic and Vascular Surgery, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
,
Meinrad Beer
6   Diagnostic and Interventional Radiology, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
7   Surgical Oncology Ulm, i2SOUL Consortium, Ulm, Germany
,
Gerhard Glatting
3   Nuclear Medicine Medical Radiation Physics, Ulm University, Ulm, Germany (Ringgold ID: RIN9189)
,
Ambros J. Beer
1   Nuclear Medicine, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
7   Surgical Oncology Ulm, i2SOUL Consortium, Ulm, Germany
,
Wolfgang Thaiss
1   Nuclear Medicine, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
6   Diagnostic and Interventional Radiology, Ulm University Hospital, Ulm, Germany (Ringgold ID: RIN27197)
7   Surgical Oncology Ulm, i2SOUL Consortium, Ulm, Germany
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Abstract

Aim The aim of this study was to derive prognostic parameters from 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG-PET/CT) in patients with low-risk NSCLC and determine their prognostic value.

Methods 81 (21 female, mean age 66 a) therapy-naive patients that underwent [18F]FDG-PET/CT before histologic confirmation of NSCLC with stadium I and II between 2008–2016 were included. A mean follow-up time of 58 months (13–176), overall and progression free survival (OS, PFS) were registered. A volume of interest for the primary tumor was defined on PET and CT images. Parameters SUVmax, PET-solidity, PET-circularity, and CT-volume were analyzed. To evaluate the prognostic value of each parameter for OS, a minimum p-value approach was used to define cutoff values, survival analysis, and log-rank tests were performed, including subgroup analysis for combinations of parameters.

Results Mean OS was 58±28 months. Poor OS was associated with a tumor CT-volume >14.3 cm3 (p=0.02, HR=7.0, CI 2.7–17.7), higher SUVmax values >12.2 (p=0.003; HR=3.0, CI 1.3–6.7) and PET-solidity >0.919 (p=0.004; HR=3.0, CI 1.0–8.9). Combined parameter analysis revealed worse prognosis in larger volume/high SUVmax tumors compared to larger volume/lower SUVmax (p=0.028; HR=2.5, CI 1.1–5.5), high PET-solidity/low volume (p=0.01; HR=2.4, CI 0.8–6.6) and low SUVmax/high PET-solidity (p=0.02, HR=4.0, CI 0.8–19.0).

Conclusion Even in this group of low-risk NSCLC patients, we identified a subgroup with a significantly worse prognosis by combining morphologic-metabolic biomarkers from [18F]FDG-PET/CT. The combination of SUVmax and CT-volume performed best. Based on these preliminary data, future prospective studies to validate this combined morphologic-metabolic imaging biomarker for potential therapeutic decisions seem promising.

Keywords

NSCLC - PET/CT - volume - SUVmax - prognostic value

Supporting information



Publikationsverlauf

Eingereicht: 23. Mai 2023

Angenommen nach Revision: 04. August 2023

Artikel online veröffentlicht:
11. September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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