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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2015

01-02-2015 | Original Article

Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis

Authors: Hyung-Jun Im, Kyoungjune Pak, Gi Jeong Cheon, Keon Wook Kang, Seong-Jang Kim, In-Joo Kim, June-Key Chung, E. Edmund Kim, Dong Soo Lee

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2015

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Abstract

Purpose

We conducted a comprehensive systematic review of the literature on volumetric parameters from 18F-FDG PET and a meta-analysis of the prognostic value of metabolic tumour volume (MTV) and total lesion glycolysis (TLG) in patients with lung cancer.

Methods

A systematic search of MEDLINE and EMBASE was performed using the keywords “positron emission tomography (PET)”, “lung cancer”, and “volume”. Inclusion criteria were: 18F-FDG PET used as an initial imaging tool; studies limited to non-small-cell lung cancer (NSCLC); volume measurement of lung cancer; patients who had not undergone surgery, chemotherapy, or radiotherapy before the PET scan; and studies that reported survival data. Event-free survival and overall survival were evaluated as outcomes. The impact of MTV and TLG on survival was measured in terms of the hazard ratio (HR) effect size. Data from each study were analysed using Review Manager 5.2.

Results

Thirteen eligible studies including 1,581 patients were analysed. Patients with high MTV showed a worse prognosis with an HR of 2.71 (95 % CI 1.82 – 4.02, p < 0.00001) for adverse events and an HR of 2.31 (95 % CI 1.54 – 3.47, p < 0.00001) for death. Patients with high TLG also showed a worse prognosis with an HR of 2.35 (95 % CI 1.91 – 2.89, p < 0.00001) for adverse events and an HR of 2.43 (95 % CI 1.89 – 3.11, p < 0.00001) for death. The prognostic value of MTV and TLG remained significant in a subgroup analysis according to TNM stage as well as the methods for defining cut-off values and tumour delineation.

Conclusion

Volumetric parameters from 18F-FDG PET are significant prognostic factors for outcome in patients with NSCLC. Patients with a high MTV or TLG are at higher risk of adverse events and death. MTV and TLG were significant prognostic factors in patients with TNM stage I/II and stage III/IV NSCLC.
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Metadata
Title
Prognostic value of volumetric parameters of 18F-FDG PET in non-small-cell lung cancer: a meta-analysis
Authors
Hyung-Jun Im
Kyoungjune Pak
Gi Jeong Cheon
Keon Wook Kang
Seong-Jang Kim
In-Joo Kim
June-Key Chung
E. Edmund Kim
Dong Soo Lee
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-014-2903-7

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