Browse > Article

Correlation of Pre-treatment FDG Uptake to Therapeutic Response and Relapse in Patients with Small Cell Lung Cancer  

Seo, Young-Soon (Departments of Nuclear Medicine, Chonnam National University Medical School)
Kwon, Seong-Young (Departments of Nuclear Medicine, Chonnam National University Medical School)
Jeong, Shin-Young (Departments of Nuclear Medicine, Chonnam National University Medical School)
Song, Ho-Chun (Departments of Nuclear Medicine, Chonnam National University Medical School)
Min, Jung-Joon (Departments of Nuclear Medicine, Chonnam National University Medical School)
Kim, Kyu-Sik (Departments of Pulmonology, Chonnam National University Medical School)
Kim, Young-Chul (Departments of Pulmonology, Chonnam National University Medical School)
Bom, Hee-Seung (Departments of Nuclear Medicine, Chonnam National University Medical School)
Publication Information
Nuclear Medicine and Molecular Imaging / v.41, no.6, 2007 , pp. 538-545 More about this Journal
Abstract
Purpose: We evaluated correlation of $^{18}F$-FDG uptakes, therapeutic response and relapse in pre-treatment $^{18}F$-FDG PET/CT in patients with SCLC. Materials and methods: We included 26 patients with pathologically proven small cell lung cancer. Total 102 lesions (26 lungs, 69 lymph nodes and 8 metastatic lesions) were evaluated. All patients underwent $^{18}F$-FDG PET/CT for staging. The maxSUV was used as a parameter of $^{18}F$-FDG uptake. The patients were divided into responders and non-responders according to response criteria on chest CT scan after 3 cycles of chemotherapy. We compared maxSUV between two groups by using independent t-test. To access correlation with $^{18}F$-FDG uptake and relapse, maxSUV and interval time to relapse was analyzed by correlation analysis. The cutoff value of maxSUV was evaluated by ROC curve. Results: Twelve-one patients (81%) were responders and five patients were non-responders on follow-up chest CT scan. The mean maxSUV of main lung lesions in responders and non-responders were $14.15{\pm}3.72$ and $9.17{\pm}2.15$, respectively. The maxSUV in the responders was significantly lower than that in non-responders (p<0.05). According to ROC curve, point of cut that predicts therapeutic response was 8.98 with 100% sensitivity and 57% specificity. The correlation analysis between $^{18}F$-FDG uptakes and interval time to relapse showed a significant negative correlation (p<0.05, r=-0.757). Conclusion: The pre-treatment $^{18}F$-FDG uptake of responders was significantly lower than that of non-responders. Patients with high $^{18}F$-FDG uptake in pre-treatment $^{18}F$-FDG PET/CT relapse earlier.
Keywords
small cell lung cancer$^{18}F$-FDG PET/CT;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Payne D, Naruke T. Lung cancer. In: Pollock RE, Manual of clinical oncology, 7th ed. New York: Wiley; 1999:385-405
2 Francis IR, Brown RK, Avram AM. The clinical role of CT/PET in oncology: an update. Cancer Imaging 2005;5:S68-75   DOI
3 Pottgen C, Levegrun S, Theegarten D, Marnitz S, Grehl S, Pink R, et al. Value of $^{18}$F-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography in non-small-cell lung cancer for prediction of pathologic response and times to relapse after neoadjuvant chemoradiotherapy. Clin Cancer Res 2006;12:97-106   DOI   ScienceOn
4 Higashi K, Ueda Y, Arisaka Y, Sakuma T, Nambu Y, Oguchi M, et al. $^{18}$F-FDG uptake as a biologic prognostic factor for recurrence in patients with surgically resected non-small cell lung cancer. J Nucl Med 2002;43:39-45
5 Cerfolio RJ, Bryant AS, Ohja B, Bartolucci AA. The maximum standardized uptake values on positron emission tomography of a non-small cell lung cancer predict stage, recurrence, and survival. J Thorac Cardiovasc Surg 2005;130:151-9   DOI   ScienceOn
6 Downey RJ, Akhurst T, Gonen M, Vincent A, Bains MS, Larson S, et al. Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection. J Clin Oncol 2004;22:3255-60   DOI   ScienceOn
7 Jackman DM, Johnson BE. Small-cell lung cancer. Lancet 2005;366:1385-96   DOI   ScienceOn
8 Wieder HA, Brcher BL, Zimmermann F, Becker K, Lordick F, Beer A, et al. Time course of tumor metabolic activity during chemoradiotherapy of esophageal squamous cell carcinoma and response to treatment. J Clin Oncol 2004;22:900-8   DOI   ScienceOn
9 Albain KS, Crowley JJ, LeBlanc M, Livingston RB. Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient Southwest Oncology Group data base. J Clin Oncol 1990;8:1563-74   DOI
10 Messa C, Bettinardi V, Picchio M, Pelosi E, Landoni C, Gianolli L, Gilardi MC, et al. PET/CT in diagnostic oncology. Q J Nucl Med Mol Imaging 2004;48:66-75
11 Pandit N, Gonen M, Krug L, Larson SM. Prognostic value of [$^{18}$F]FDG-PET imaging in small cell lung cancer. Eur J Nucl Med Mol Imaging 2003;30:78-84   DOI
12 Oriuchi N, Higuchi T, Ishikita T, Miyakubo M, Hanaoka H, Iida Y, et al. Present role and future prospects of positron emission tomography in clinical oncology. Cancer Sci 2006;97:1291-7   DOI   ScienceOn
13 Eschmann SM, Friedel G, Paulsen F, Reimold M, Hehr T, Budach W, et al. Is standardised (18)F-FDG uptake value an outcome predictor in patients with stage III non-small cell lung cancer? Eur J Nucl Med Mol Imaging 2006;33:263-9   DOI
14 Sing T, Wu F, Brodiin O, Fasth KJ, Langstrom B, Bergstrom M. In vitro PET evaluation in lung cancer cell lines. Anticancer Res 2000;20:1375-80
15 von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology 2006;238: 405-22   DOI   ScienceOn
16 Hellwig D, Groschel A, Graeter TP, Hellwig AP, Nestle U, Schafers HJ, et al. Diagnostic performance and prognostic impact of FDG-PET in suspected recurrence of surgically treated non-small cell lung cancer. Eur J Nucl Med Mol Imaging 2006;33:13-21   DOI
17 Hellwig D, Graeter TP, Ukena D, Georg T, Kirsch CM, Schafers HJ. Value of F-18-fluorodeoxyglucose positron emission tomography after induction therapy of locally advanced bronchogenic carcinoma. Thorac Cardiovasc Surg 2004 ;128:892-9   DOI
18 Rizk N, Downey RJ, Akhurst T, Gonen M, Bains MS, Larson S, et al. Preoperative $^{18}$[F]-fluorodeoxyglucose positron emission tomography standardized uptake values predict survival after esophageal adenocarcinoma resection. Ann Thorac Surg 2006;81:1076-81   DOI   ScienceOn
19 Smith IC, Welch AE, Hutcheon AW, Miller ID, Payne S, Chilcott F, et al. Positron emission tomography using [(18)F]-fluorodeoxy- D-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol 2000;18:1676-88   DOI
20 Osterlind K, Andersen PK. Prognostic factors in small cell lung cancer: multivariate model based on 778 patients treated with chemotherapy with or without irradiation. Cancer Res 1986;46: 4189-94
21 Gagel B, Reinartz P, Demirel C, Kaiser HJ, Zimny M, Piroth M, et al. [$^{18}$F] fluoromisonidazole and [$^{18}$F] fluorodeoxyglucose positron emission tomography in response evaluation after chemo-/ radiotherapy of non-small-cell lung cancer: a feasibility study. BMC Cancer 2006;6:51   DOI
22 Vansteenkiste JF, Stroobants SG, Dupont PJ, De Leyn PR, Verbeken EK, Deneffe GJ, et al. Prognostic importance of the standardized uptake value on (18)F-fluoro-2-deoxy-glucose-positron emission tomography scan in non-small-cell lung cancer: An analysis of 125 cases. Leuven Lung Cancer Group. J Clin Oncol 1999;17:3201-6   DOI
23 Eschmann SM, Friedel G, Paulsen F, Reimold M, Hehr T, Budach W, et al. Repeat $^{18}$F-FDG PET for monitoring neoadjuvant chemotherapy in patients with stage III non-small cell lung cancer. Lung Cancer 2007;55:165-71   DOI   ScienceOn
24 Borst GR, Belderbos JS, Boellaard R, Comans EF, De Jaeger K, Lammertsma AA, et al. Standardised FDG uptake: a prognostic factor for inoperable non-small cell lung cancer. Eur J Cancer 2005;41:1533-41   DOI   ScienceOn
25 Ohtsuka T, Nomori H, Watanabe K, Kaji M, Naruke T, Suemasu K, et al. Prognostic significance of [(18)F]fluorodeoxyglucose uptake on positron emission tomography in patients with pathologic stage I lung adenocarcinoma. Cancer 2006;107:2468-73   DOI   ScienceOn
26 Blum R, MacManus MP, Rischin D, Michael M, Ball D, Hicks RJ. Impact of positron emission tomography on the management of patients with small cell lung cancer preliminary experience. Am J Clin Oncol 2004;27:164-71   DOI   ScienceOn
27 Paesmans M, Sculier JP, Lecomte J, Thiriaux J, Libert P, Sergysels R, et al. Prognostic factors for patients with small cell lung carcinoma: analysis of a series of 763 patients included in 4 consecutive prospective trials with a minimum follow-up of 5 years. Cancer 2000;89:523-33   DOI   ScienceOn
28 Coleman RE. Clinical PET in Oncology. Clin Positron Imaging 1998;1:15-30   DOI   ScienceOn
29 Lee KH, Lee SH, Kim DW, Kang WJ, Chung JK, Im SA, et al. High fluorodeoxyglucose uptake on positron emission tomography in patients with advanced non-small cell lung cancer on platinum-based combination chemotherapy. Clin Cancer Res 2006; 15:4232-6
30 Meert AP, Paesmans M, Berghmans T, Martin B, Mascaux C, Vallot F, et al. Prophylactic cranial irradiation in small cell lung cancer: a systemic review of the literature with meta-analysis. BMC cancer 2001;1:5   DOI
31 S.-J. Kim, S.-k. Kim, E. S. Lee, J. Ro & S. h. Kang. Predictive value of [18F]FDG PET for pathological response of breast cancer to neo-adjuvant chemotherapy. Ann Oncol 2004;15:1352-1357   DOI   ScienceOn
32 Mountain CF. Revision in the international system for staging lung cancer. Chest 1997;111:1710-7   DOI   ScienceOn
33 Hicks RJ, Kalff V, MacManus MP, Ware RE, McKenzie AF, Matthews JP, et al. The utility of (18)F-FDG PET for suspected recurrent non-small cell lung cancer after potentially curative therapy: impact on management and prognostic stratification. J Nucl Med 2001;42:1605-13
34 Wolf M, Holle R, Hans K, Drings P, Havemann K. Analysis of prognostic factors in 766 patients with small cell lung cancer (SCLC): the role of sex as a predictor for survival. Br J Cancer 1991;63:986-92   DOI   ScienceOn
35 Brink I, Schumacher T, Mix M, Ruhland S, Stoelben E, Digel W, et al. Impact of F-18-FDG-PET on the primary staging of small cell lung cancer. Eur J Nucl Med Mol Imaging 2004;31:1614-20   DOI
36 Spiegelman D, Maurer LH, Ware JH, Perry MC, Chahinian AP, Comis R, Eaton W, et al. Prognostic factors in small-cell carcinoma of the lung: an analysis of 1,521 patients. J Clin Oncol 1989; 7:344-54   DOI