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Open Access 09-05-2024 | Computed Tomography | Original Article

The impact of PET/CT and brain MRI for metastasis detection among patients with clinical T1-category lung cancer: Findings from a large-scale cohort study

Authors: Yi Feng, Bo Cheng, Shuting Zhan, Haiping Liu, Jianfu Li, Peiling Chen, Zixun Wang, Xiaoyan Huang, Xiuxia Fu, Wenjun Ye, Runchen Wang, Qixia Wang, Yang Xiang, Huiting Wang, Feng Zhu, Xin Zheng, Wenhai Fu, Guodong Hu, Zhuxing Chen, Jianxing He, Wenhua Liang

Published in: European Journal of Nuclear Medicine and Molecular Imaging

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Abstract

Purpose

[18F]-FDG PET/CT and brain MRI are common approaches to detect metastasis in patients of lung cancer. Current guidelines for the use of PET/CT and MRI in clinical T1-category lung cancer lack risk-based stratification and require optimization. This study stratified patients based on metastatic risk in terms of the lesions' size and morphological characteristics.

Methods

The detection rate of metastasis was measured in different sizes and morphological characteristics (solid and sub-solid) of tumors. To confirm the cut-off value for discriminating metastasis and overall survival (OS) prediction, the receiver operating characteristic (ROC) analysis was performed based on PET/CT metabolic parameters (SUVmax/SUVmean/SULpeak/MTV/TLG), followed by Kaplan–Meier analysis for survival in post-operation patients with and without PET/CT plus MRI.

Results

2,298 patients were included. No metastasis was observed in patients with solid nodules < 8.0 mm and sub-solid nodules < 10.0 mm. The cut-off of PET/CT metabolic parameters on discriminating metastasis were 1.09 (SUVmax), 0.26 (SUVmean), 0.31 (SULpeak), 0.55 (MTV), and 0.81 (TLG), respectively. Patients undergoing PET/CT plus MRI exhibited longer OS compared to those who did not receive it in solid nodules ≥ 8.0 mm & sub-solid nodules ≥ 10.0 mm (HR, 0.44; p < 0.001); in solid nodules ≥ 8.0 mm (HR, 0.12; p<0.001) and in sub-solid nodules ≥ 10.0 mm (HR; 0.61; p=0.075), respectively. Compared to patients with metabolic parameters lower than cut-off values, patients with higher metabolic parameters displayed shorter OS: SUVmax (HR, 12.94; p < 0.001), SUVmean (HR, 11.33; p <0.001), SULpeak (HR, 9.65; p < 0.001), MTV (HR, 9.16; p = 0.031), and TLG (HR, 12.06; p < 0.001).

Conclusion

The necessity of PET/CT and MRI should be cautiously evaluated in patients with solid nodules < 8.0 mm and sub-solid nodules < 10.0 mm, however, these examinations remained essential and beneficial for patients with solid nodules ≥ 8.0 mm and sub-solid nodules ≥ 10.0 mm.
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Literature
8.
go back to reference Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals Oncol Off J Eur Soc Med Oncol. 2017;28:iv1–21. https://doi.org/10.1093/annonc/mdx222.CrossRef Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals Oncol Off J Eur Soc Med Oncol. 2017;28:iv1–21. https://​doi.​org/​10.​1093/​annonc/​mdx222.CrossRef
9.
go back to reference Asamura H, Chansky K, Crowley J, Goldstraw P, Rusch VW, Vansteenkiste JF, et al. The international association for the study of lung cancer lung cancer staging project: Proposals for the revision of the N Descriptors in the Forthcoming 8th Edition of the TNM Classification for Lung Cancer. J Thorac Oncol Off Public Int Assoc Study Lung Cancer. 2015;10:1675–84. https://doi.org/10.1097/jto.0000000000000678. Asamura H, Chansky K, Crowley J, Goldstraw P, Rusch VW, Vansteenkiste JF, et al. The international association for the study of lung cancer lung cancer staging project: Proposals for the revision of the N Descriptors in the Forthcoming 8th Edition of the TNM Classification for Lung Cancer. J Thorac Oncol Off Public Int Assoc Study Lung Cancer. 2015;10:1675–84. https://​doi.​org/​10.​1097/​jto.​0000000000000678​.
13.
go back to reference Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM classification for lung cancer. J Thorac Oncol Off Public Intern Assoc Study Lung Cancer. 2016;11:39–51. https://doi.org/10.1016/j.jtho.2015.09.009.CrossRef Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM classification for lung cancer. J Thorac Oncol Off Public Intern Assoc Study Lung Cancer. 2016;11:39–51. https://​doi.​org/​10.​1016/​j.​jtho.​2015.​09.​009.CrossRef
14.
go back to reference Efron B. The efficiency of Cox’s likelihood function for censoreddata. J Am Stat Assoc. 1977;72:557–65.CrossRef Efron B. The efficiency of Cox’s likelihood function for censoreddata. J Am Stat Assoc. 1977;72:557–65.CrossRef
18.
go back to reference Hallqvist A, Alverbratt C, Strandell A, Samuelsson O, Björkander E, Liljegren A, et al. Positron emission tomography and computed tomographic imaging (PET/CT) for dose planning purposes of thoracic radiation with curative intent in lung cancer patients: A systematic review and meta-analysis. Radiother Oncol J Eur Soc Therap Radiol Oncol. 2017;123:71–7. https://doi.org/10.1016/j.radonc.2017.02.011.CrossRef Hallqvist A, Alverbratt C, Strandell A, Samuelsson O, Björkander E, Liljegren A, et al. Positron emission tomography and computed tomographic imaging (PET/CT) for dose planning purposes of thoracic radiation with curative intent in lung cancer patients: A systematic review and meta-analysis. Radiother Oncol J Eur Soc Therap Radiol Oncol. 2017;123:71–7. https://​doi.​org/​10.​1016/​j.​radonc.​2017.​02.​011.CrossRef
Metadata
Title
The impact of PET/CT and brain MRI for metastasis detection among patients with clinical T1-category lung cancer: Findings from a large-scale cohort study
Authors
Yi Feng
Bo Cheng
Shuting Zhan
Haiping Liu
Jianfu Li
Peiling Chen
Zixun Wang
Xiaoyan Huang
Xiuxia Fu
Wenjun Ye
Runchen Wang
Qixia Wang
Yang Xiang
Huiting Wang
Feng Zhu
Xin Zheng
Wenhai Fu
Guodong Hu
Zhuxing Chen
Jianxing He
Wenhua Liang
Publication date
09-05-2024
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-024-06740-8