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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-11-2018 | Original Article

FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients

Authors: E. Incerti, S. Broggi, A. Fodor, M. Cuzzocrea, A. M. Samanes Gajate, P. Mapelli, C. Fiorino, I. Dell’Oca, M. Pasetti, M. Cattaneo, R. Calandrino, L. Gianolli, N. Di Muzio, Maria Picchio

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

Abstract

Purpose

The value of FDG PET-derived parameters in predicting overall survival (OS), local relapse-free survival (LRFS) and distant relapse-free survival (DRFS) in treated patients with malignant pleural mesothelioma (MPM) was evaluated.

Methods

This retrospective evaluation included 55 MPM patients treated between March 2006 and February 2015 with FDG PET/CT-guided salvage helical tomotherapy (HTT) after previous surgery plus chemotherapy. Univariate Cox regression analysis was performed to assess the impact of the following FDG PET-derived parameters: biological target volume (BTV), mean and maximum standardized uptake values (SUV_mean/max), metabolic tumour volume (MTV) and total lesion glycolysis (TLG), measured using different uptake thresholds (40%, 50% and 60%). Logistic regression was then performed to identify the best FDG PET-derived parameters for selecting patients with poorer survival.

Results

The median OS was 9.1 months (range 0.0 – 69.6 months) after the end of HTT; 54/55 patients were dead at the last follow-up. BTV and TLG40, TLG50 and TLG60 were the most significant predictors of OS (p < 0.005). The median OS was 4.8 months in patients with MTV60 >5 cm³ and TLG40 >334.4, compared with 13.8 months and 16.1 months in patients with smaller values, respectively. The median LRFS and DRFS were 6.2 months (range 1.2 – 39.4 months) and 6.5 months (0.0 – 66.4 months), respectively. TLG40, TLG50 and TLG60 were significantly correlated with LRFS (p < 0.015). Median DRFS was 6.4 months in patients with MTV40 >39.6 cm³ and 6.2 months in patients with TLG40 >334.4, compared with 17 months and 18.8 months in patients with smaller values. BTV, TLG40 and MTV40 were also found to be good predictors in patients with poor OS/LRFS/DRFS (median survival times less than the median values).

Conclusion

FDG PET-derived parameters effectively discriminated patients with a poor prognosis and may be helpful in the selection of MPM patients for salvage HTT.

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Title: FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients
Authors: E. Incerti
S. Broggi
A. Fodor
M. Cuzzocrea
A. M. Samanes Gajate
P. Mapelli
C. Fiorino
I. Dell’Oca
M. Pasetti
M. Cattaneo
R. Calandrino
L. Gianolli
N. Di Muzio
Maria Picchio
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/s00259-018-4056-6

At a glance: The STEP trials

Springer Medicine

FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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