Prognostic value of different metabolic measurements with fluorine-18 fluorodeoxyglucose positron emission tomography in resectable non-small cell lung cancer: a two-center study

W. de Jong, H. van der Heijden, J. Pruim, O. Dalesio, W. Oyen and H. Groen

Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Nov, 2007



Standard uptake value (SUV) is a quantitative measure for the preferential uptake of a radiopharmaceutical in a tumor compared with the homogeneous distribution in the body. SUV can be based on the maximal value of one pixel (SUVmax) or on the mean value in a region outlined by isodensity contours. The prognostic value of different SUVs in non-small cell lung cancer (NSCLC) is not established. We evaluated this value for SUVmax, SUV70\%, and SUV50\% among patients with resectable NSCLC.All consecutive patients with resectable NSCLC who underwent an attenuation-corrected whole-body fluorine-18 fluorodeoxyglucose positron emission tomography scan from two university hospitals were selected. By adjusting the isocontour in the region of interest on the scan, SUVmax, SUV70\%, and SUV50\% of the primary tumor were calculated.Sixty-six patients (50 male, median age 63 years) were included. Of the tumors, 16 were pathological stage IA, 23 were IB, 4 were IIA, 14 were IIB, and 9 were IIIA. Median (range) values for SUVmax, SUV70\%, and SUV50\% were 6.4 (1.6-19.1), 5.1 (1.0-15.7), and 4.0 (0.9-13.4), respectively. SUVs were associated with survival. Analysis of residuals of SUVmax as a continuous variable in a Cox's proportional hazard model for survival suggested no cutoff point and no indication of time-dependency. Patients with a SUV higher than the median value had a worse survival than patients with a SUV lower than median (hazard ratios for SUVmax, SUV70\%, and SUV50\% all were 2.9; p = 0.02).SUVmax, SUV70\%, and SUV50\% measured with fluorine-18 fluorodeoxyglucose positron emission tomography have a similar prognostic value, and no "natural" cutoff point for SUVmax in resectable NSCLC was identified.