Prognostic value of various metabolic parameters on pre-treatment 18-F-FDG PET/CT in patients with stage I-III non-small cell lung cancer

the aim of this study was to investigate the prognostic value of 18Fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters in both overall survival and progression-free survival in Stage I-III non-small cell lung cancer (NSCLC).

In this retrospective study, 267 patients who were diagnosed as Stage I-III non-small cell lung cancer and had undergone FDG-PET/CT imaging before treatment were included. PET/CT parameters, maximum and mean standardized uptake values (SUVmax and SUVmean), metabolic tumor volume (MTV), total lesional glycolysis (TLG), and maximum tumor-to-blood standard uptake ratio (SURmax) were calculated. Analyses were performed to evaluate the ability of PET parameters to predict recurrence and death as well as to determine prognostic value.

In predicting both mortality and progression, the area under the ROC curve (AUC) value was highest for TLG (AUC: 0.717, 0.692 respectively). Overall survival was lower in patients with TLG> 214, and progression-free survival was lower in patients with TLG> 194. All PET parameters had a prognostic value in univariate analysis. Age, N1 stage and SUVmean were independent prognostic factors in multivariate analysis.

In predicting death and progression, TLG had the highest predictive value. Age and N1 stage were independent prognostic factors in multivariate analysis, while SUVmean was the most valuable independent prognostic factor.