The association of (18)F-FDG PET/CT parameters with survival in malignant pleural mesothelioma

TY - JOUR

T1 - The association of (18)F-FDG PET/CT parameters with survival in malignant pleural mesothelioma

AU - Klabatsa, Astero

AU - Chicklore, Sugama

AU - Barrington, Sally F

AU - Goh, Vicky

AU - Lang-Lazdunski, Loic

AU - Cook, Gary J R

PY - 2014/2

Y1 - 2014/2

N2 - PurposeMalignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-18-FDG PET/CT).MethodsIn order to determine the relationships between metabolic activity and prognosis we reviewed all F-18-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n = 60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes.ResultsMedian follow-up was 12.7 months (1.9-60.9) and median OS was 14.1 months (1.9-54.9). By univariable analysis histological subtype (p = 0.013), TLG (p = 0.024) and MTV (p = 0.038) were significantly associated with OS and SUVmax was borderline (p = 0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p = 0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes.ConclusionF-18-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials.

AB - PurposeMalignant pleural mesothelioma (MPM) is a disease with poor prognosis despite multimodal therapy but there is variation in survival between patients. Prognostic information is therefore potentially valuable in managing patients, particularly in the context of clinical trials where patients could be stratified according to risk. Therefore we have evaluated the prognostic ability of parameters derived from baseline 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (F-18-FDG PET/CT).MethodsIn order to determine the relationships between metabolic activity and prognosis we reviewed all F-18-FDG PET/CT scans used for pretreatment staging of MPM patients in our institution between January 2005 and December 2011 (n = 60) and measured standardised uptake values (SUV) including mean, maximum and peak values, metabolic tumour volume (MTV) and total lesion glycolysis (TLG). Overall survival (OS) or time to last censor was recorded, as well as histological subtypes.ResultsMedian follow-up was 12.7 months (1.9-60.9) and median OS was 14.1 months (1.9-54.9). By univariable analysis histological subtype (p = 0.013), TLG (p = 0.024) and MTV (p = 0.038) were significantly associated with OS and SUVmax was borderline (p = 0.051). On multivariable analysis histological subtype and TLG were associated with OS but at borderline statistical significance (p = 0.060 and 0.058, respectively). No statistically significant differences in any PET parameters were found between the epithelioid and non-epithelioid histological subtypes.ConclusionF-18-FDG PET/CT parameters that take into account functional volume (MTV, TLG) show significant associations with survival in patients with MPM before adjusting for histological subtype and are worthy of further evaluation to determine their ability to stratify patients in clinical trials.

KW - Mesothelioma

KW - F-18-FDG PET/CT

KW - Prognosis

KW - Standardised uptake value

KW - Total lesion glycolysis

KW - Metabolic tumour volume

KW - POSITRON-EMISSION-TOMOGRAPHY

KW - EXTRAPLEURAL PNEUMONECTOMY

KW - COMPUTED-TOMOGRAPHY

KW - RESPONSE EVALUATION

KW - PROGNOSTIC VALUE

KW - FDG-PET/CT

KW - CHEMOTHERAPY

KW - CANCER

KW - PREDICTION

KW - MANAGEMENT

U2 - 10.1007/s00259-013-2561-1

DO - 10.1007/s00259-013-2561-1

M3 - Article

C2 - 24057459

SN - 1619-7070

VL - 41

SP - 276

EP - 282

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

IS - 2

ER -