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Prognostic Usefulness of Maximum Standardized Uptake Value on FDG-PET in Surgically Resected Non-small-cell Lung Cancer  

Nguyen Xuan Canh (Department of Nuclear Medicine, Seoul National University College of Medicine)
Lee Won-Woo (Department of Nuclear Medicine, Seoul National University College of Medicine)
Sung Sook-Whan (Department of Thoracic Surgery, Seoul National University College of Medicine)
Jheon Sang-Hoon (Department of Thoracic Surgery, Seoul National University College of Medicine)
Kim Yu-Kyeong (Department of Nuclear Medicine, Seoul National University College of Medicine)
Lee Dong-Soo (Department of Nuclear Medicine, Seoul National University College of Medicine)
Chung June-Key (Department of Nuclear Medicine, Seoul National University College of Medicine)
Lee Myung-Chul (Department of Nuclear Medicine, Seoul National University College of Medicine)
Kim Sang-Eun (Department of Nuclear Medicine, Seoul National University College of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.40, no.4, 2006 , pp. 205-210 More about this Journal
Abstract
Purpose: FDG uptake on positron omission tomography (PET) has been considered a prognostic indicator in non-small cell lung cancer (NSCLC). The aim of this study was to assess the clinical significance of maximum value of SUV (maxSUV) in recurrence prediction in patients with surgically resected NSCLC. Materials & methods: NSCLC patients (n=42, F:M =14:28, age $62.3{\pm}12.3$ y) who underwent curative resection after FDG-PET were enrolled. Twenty-nine patients had pathologic stage 1, and 13 had pathologic stage II. Thirty-one patients were additionally treated with adjuvant oral chemotherapy. MaxSUVs of primary tumors were analyzed for correlation with tumor recurrence and compared with pathologic or clinical prognostic indicators. The median follow-up duration was 16 mo (range, 3-26 mo). Results: Ten (23.8%) of the 42 patients experienced recurrence during a median follow-up of 7.5 mo (range, 3-13 mo). Univariate analysis revealed that disease-free survival (DFS) was significantly correlated with maxSUV (<7 vs. $\geq7$, p=0.006), tumor size (<3 cm vs. $\geq3$ cm, p=0.024), and tumor tell differentiation (well/moderate vs. poor, p=0.044). However, multivariate Cox proportional analysis identified maxSUV as the single determinant for DFS (p=0.014). Patients with a maxSUV of $\geq7$(n=10) had a significantly lower 1-year DFS rate (50.0%) than those with a maxSUV of <7 (n=32, 87.5%). Conclusion: MaxSUV is a significant independent predictor for recurrence in surgically resected NSCLC. FDG uptake can be added to other well-known factors in prognosis prediction of NSCLC.
Keywords
FDG uptake; non-small-cell lung cancer; positron emission tomography; F-18 fluorodeoxyglucose; prognosis;
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