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European Journal of Nuclear Medicine and Molecular Imaging

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01-11-2018 | Original Article

Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging

Authors: Yonglin Pu, James X. Zhang, Haiyan Liu, Daniel Appelbaum, Jianfeng Meng, Bill C. Penney

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2018

Abstract

Purpose

We hypothesized that whole-body metabolic tumor volume (MTVwb) could be used to supplement non-small cell lung cancer (NSCLC) staging due to its independent prognostic value. The goal of this study was to develop and validate a novel MTVwb risk stratification system to supplement NSCLC staging.

Methods

We performed an IRB-approved retrospective review of 935 patients with NSCLC and FDG-avid tumor divided into modeling and validation cohorts based on the type of PET/CT scanner used for imaging. In addition, sensitivity analysis was conducted by dividing the patient population into two randomized cohorts. Cox regression and Kaplan-Meier survival analyses were performed to determine the prognostic value of the MTVwb risk stratification system.

Results

The cut-off values (10.0, 53.4 and 155.0 mL) between the MTVwb quartiles of the modeling cohort were applied to both the modeling and validation cohorts to determine each patient’s MTVwb risk stratum. The survival analyses showed that a lower MTVwb risk stratum was associated with better overall survival (all p < 0.01), independent of TNM stage together with other clinical prognostic factors, and the discriminatory power of the MTVwb risk stratification system, as measured by Gönen and Heller’s concordance index, was not significantly different from that of TNM stage in both cohorts. Also, the prognostic value of the MTVwb risk stratum was robust in the two randomized cohorts. The discordance rate between the MTVwb risk stratum and TNM stage or substage was 45.1% in the modeling cohort and 50.3% in the validation cohort.

Conclusion

This study developed and validated a novel MTVwb risk stratification system, which has prognostic value independent of the TNM stage and other clinical prognostic factors in NSCLC, suggesting that it could be used for further NSCLC pretreatment assessment and for refining treatment decisions in individual patients.

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Title: Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging
Authors: Yonglin Pu
James X. Zhang
Haiyan Liu
Daniel Appelbaum
Jianfeng Meng
Bill C. Penney
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-4059-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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