Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 9/2016

01-09-2016 | Chest

The Role of 18F-FDG PET/CT on Staging and Prognosis in Patients with Small Cell Lung Cancer

Authors: A. Zer, L. Domachevsky, Y. Rapson, M. Nidam, D. Flex, A. M. Allen, S. M. Stemmer, D. Groshar, H. Bernstine

Published in: European Radiology | Issue 9/2016

Login to get access

Abstract

Background

We evaluated 18F-FDG PET/CT in small cell lung cancer (SCLC) staging and assessed metabolic (SUVmax, MTV and TLG) and morphologic (CTvol) variables as predictors for overall survival (OS) and progression-free survival (PFS).

Methods

Patients with newly diagnosed, histopathology-confirmed SCLC, who underwent 18F-FDG PET/CT were evaluated. A Cox proportional hazard model was used to determine the association between the primary tumour SUVmax, MTV, TLG and CTvol with OS and PFS. Similar evaluations were performed when hilar/mediastinal lymphadenopathy was included [total SUVmax (TSUVmax), total MTV (TMTV) and total TLG (TTLG)].

Results

55 patients were included. 18F-FDG PET/CT changed staging in 6/55 (10.9%) patients who were upstaged to extensive disease. TTLG (>443.8) was a significant variable for OS with HR=2.1 (CI 1.14–3.871, p=0.017). Patients with TTLG>443.8 had a median OS of 13.4 months compared to 25.7 months in patients with TTLG<443.8 (p=0.018). TMTV (>72.4) was significant for PFS with HR=2.3 (CI 1.11-4.8, p=0.025). A median PFS of 12.1 and 26.2 months was found with TMTV greater and less than 72.4, respectively (p=0.005).

Conclusions

18F-FDG PET/CT improved staging of patients with SCLC, and TTLG and TMTV can be used as prognostic variables for OS and PFS, respectively.

Key Points

• Identifying variables that predict the prognosis of patients with SCLC is important.
• 18F-FDG PET/CT influences staging of patients with SCLC.
• Metabolic parameters could be used as predictors for PFS and OS.
Literature
1.
Karve SJ, Price GL, Davis KL, Pohl GM, Smyth E, Bowman L (2014) Comparison of demographics, treatment patterns, health care utilization, and costs among elderly patients with extensive-stage small cell and metastatic non-small cell lung cancers. BMC Health Serv Res 14(1):555CrossRefPubMedPubMedCentral
2.
Van Meerbeeck JP, Fennell DA, De Ruysscher DKM (2011) Small-cell lung cancer. Lancet 378(9804):1741–1755CrossRefPubMed
3.
Brink I, Schumacher T, Mix M et al (2004) Impact of [18F] FDG-PET on the primary staging of small-cell lung cancer. Eur J Nuc Med Mol Imaging 31(12):1614–1620
4.
Diniz G, Unlu I, Gokce T et al (2006) Evaluation of curative and palliative radiotherapy efficacy in extensive stage small cell lung cancer. Saudi Med J 27(7):992–996PubMed
5.
6.
Al-Sarraf N, Gately K, Lucey J et al (2008) Clinical implication and prognostic significance of standardised uptake value of primary non-small cell lung cancer on positron emission tomography: analysis of 176 cases. Eur J Cardio Thorac Surg Off J Eur Assoc Cardio Thorac Surg 34(4):892–897CrossRef
7.
Zhang H, Wroblewski K, Appelbaum D, Pu Y (2013) Independent prognostic value of whole-body metabolic tumor burden from FDG-PET in non-small cell lung cancer. Int J Comput Assist Radiol Surg 8(2):181–191CrossRefPubMed
8.
Lee YJ, Cho A, Cho BC et al (2009) High tumor metabolic activity as measured by fluorodeoxyglucose positron emission tomography is associated with poor prognosis in limited and extensive stage small-cell lung cancer. Clin Cancer Res Off J Am Assoc Cancer Res 15(7):2426–2432CrossRef
9.
10.
Thomson D, Hulse P, Lorigan P, Faivre-Finn C (2011) The role of positron emission tomography in management of small cell lung cancer. Lung Cancer Amst Neth 73(2):121–126CrossRef
11.
Ruben JD, Ball DL (2012) The efficacy of PET staging for small-cell lung cancer: a systematic review and cost analysis in the Australian setting. J Thorac Oncol Off Publ Int Assoc Study Lung Cancer 7(6):1015–1020
12.
Fischer BM, Mortensen J, Langer SW et al (2007) A prospective study of PET/CT in initial staging of small-cell lung cancer: comparison with CT, bone scintigraphy and bone marrow analysis. Ann Oncol Off J Eur Soc Med Oncol ESMO 18(2):338–345CrossRef
13.
Foster NR, Mandrekar SJ, Schild SE et al (2009) Prognostic factors differ by tumor stage for small cell lung cancer: a pooled analysis of North Central Cancer Treatment Group trials. Cancer 115(12):2721–2731CrossRefPubMedPubMedCentral
14.
Pandit N, Gonen M, Krug L, Larson SM (2003) Prognostic value of [18F]FDG-PET imaging in small cell lung cancer. Eur J Nucl Med Mol Imaging 30(1):78–84CrossRefPubMed
15.
Arslan N, Tuncel M, Kuzhan O et al (2011) Evaluation of outcome prediction and disease extension by quantitative 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography in patients with small cell lung cancer. Ann Nucl Med 25(6):406–413CrossRefPubMed
Metadata
Title
The Role of 18F-FDG PET/CT on Staging and Prognosis in Patients with Small Cell Lung Cancer
Authors
A. Zer
L. Domachevsky
Y. Rapson
M. Nidam
D. Flex
A. M. Allen
S. M. Stemmer
D. Groshar
H. Bernstine
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4132-2

Other articles of this Issue 9/2016

European Radiology 9/2016 Go to the issue

Cardiac

AHA classification of coronary and carotid atherosclerotic plaques by grating-based phase-contrast computed tomography

Neuro

Comparison of Imaging Selection Criteria for Intra-Arterial Thrombectomy in Acute Ischemic Stroke with Advanced CT

Cardiac

Quantitative evaluation of beam-hardening artefact correction in dual-energy CT myocardial perfusion imaging

Nuclear Medicine

The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using 99mTc-ECD SPECT

Hepatobiliary-Pancreas

Hepatic sarcoidosis in patients presenting with liver dysfunction: imaging appearance, pathological correlation and disease evolution

Health Economy

Double versus single reading of mammograms in a breast cancer screening programme: a cost-consequence analysis