Prognostic Value of Metabolic Information in Advanced Gastric Cancer Using Preoperative 18F-FDG PET/CT

Hye Ryeong Kwon; Kisoo Pahk; Sungsoo Park; Hyun Woo Kwon; Sungeun Kim

doi:10.1007/s13139-019-00622-w

Prognostic Value of Metabolic Information in Advanced Gastric Cancer Using Preoperative ¹⁸F-FDG PET/CT

Hye Ryeong Kwon, Kisoo Pahk, Sungsoo Park, Hyun Woo Kwon, Sungeun Kim

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Purpose: This study evaluated the usefulness of semiquantitative and volumetric PET parameters for predicting prognosis in patients with advanced gastric cancer (AGC). Methods: We enrolled 213 patients who underwent ¹⁸F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) prior to curative surgery for AGC. Maximum standardized uptake value (SUVmax) and tumor-to-liver uptake ratio (TLR) were measured in all patients. Metabolic tumor volume (MTV) and total lesion glycolysis were measured in volume-measurable patients. For further quantification of FDG uptake, we developed PET prognostic scores by combining SUVmax and MTV (1: low SUVmax/low MTV; 2: high SUVmax/low MTV; 3: high SUVmax/high MTV). Comparison of PET parameters between recurrence and non-recurrence groups was performed. Univariate and multivariate analyses for recurrence-free survival (RFS) and overall survival (OS) were subsequently performed. Results: The recurrence rate was 32.4% (69/213 patients). Mean SUVmax and mean MTV of the recurrence group were significantly higher than those of the non-recurrence group (p = 0.026 and p = 0.025). TLR showed marginal significance (p = 0.051). In multivariate analysis for RFS including all patients, SUVmax (p = 0.022), TLR (p = 0.010), and PET score (p = 0.003) were independent prognostic factors. In post hoc analysis of PET score, significant differences in RFS were observed between PET scores 2 and 3 as well as scores 1 and 3. No significant difference in RFS was observed between scores 1 and 2. Only PET score was statistically significant for OS in univariate analysis. None of the PET parameters were statistically significant for OS in multivariate analysis. Conclusion: High SUVmax and high MTV of the primary tumor suggest a high risk of recurrence for AGC patients. Even if SUVmax is similar, the prognosis may vary depending on MTV. Combining PET parameters results in a better prediction for prognosis.

Original language	English
Pages (from-to)	386-395
Number of pages	10
Journal	Nuclear Medicine and Molecular Imaging
Volume	53
Issue number	6
DOIs	https://doi.org/10.1007/s13139-019-00622-w
Publication status	Published - 2019 Dec 1

Keywords

Advanced gastric cancer
FDG PET/CT
Maximum standardized uptake value
Metabolic tumor volume
Recurrence

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s13139-019-00622-w

Cite this

@article{a29ced66f3da44dca0c9e57b8ead57cc,

title = "Prognostic Value of Metabolic Information in Advanced Gastric Cancer Using Preoperative 18F-FDG PET/CT",

abstract = "Purpose: This study evaluated the usefulness of semiquantitative and volumetric PET parameters for predicting prognosis in patients with advanced gastric cancer (AGC). Methods: We enrolled 213 patients who underwent 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) prior to curative surgery for AGC. Maximum standardized uptake value (SUVmax) and tumor-to-liver uptake ratio (TLR) were measured in all patients. Metabolic tumor volume (MTV) and total lesion glycolysis were measured in volume-measurable patients. For further quantification of FDG uptake, we developed PET prognostic scores by combining SUVmax and MTV (1: low SUVmax/low MTV; 2: high SUVmax/low MTV; 3: high SUVmax/high MTV). Comparison of PET parameters between recurrence and non-recurrence groups was performed. Univariate and multivariate analyses for recurrence-free survival (RFS) and overall survival (OS) were subsequently performed. Results: The recurrence rate was 32.4% (69/213 patients). Mean SUVmax and mean MTV of the recurrence group were significantly higher than those of the non-recurrence group (p = 0.026 and p = 0.025). TLR showed marginal significance (p = 0.051). In multivariate analysis for RFS including all patients, SUVmax (p = 0.022), TLR (p = 0.010), and PET score (p = 0.003) were independent prognostic factors. In post hoc analysis of PET score, significant differences in RFS were observed between PET scores 2 and 3 as well as scores 1 and 3. No significant difference in RFS was observed between scores 1 and 2. Only PET score was statistically significant for OS in univariate analysis. None of the PET parameters were statistically significant for OS in multivariate analysis. Conclusion: High SUVmax and high MTV of the primary tumor suggest a high risk of recurrence for AGC patients. Even if SUVmax is similar, the prognosis may vary depending on MTV. Combining PET parameters results in a better prediction for prognosis.",

keywords = "Advanced gastric cancer, FDG PET/CT, Maximum standardized uptake value, Metabolic tumor volume, Recurrence",

author = "Kwon, {Hye Ryeong} and Kisoo Pahk and Sungsoo Park and Kwon, {Hyun Woo} and Sungeun Kim",

note = "Publisher Copyright: {\textcopyright} 2019, Korean Society of Nuclear Medicine.",

year = "2019",

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day = "1",

doi = "10.1007/s13139-019-00622-w",

language = "English",

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journal = "Nuclear Medicine and Molecular Imaging",

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T1 - Prognostic Value of Metabolic Information in Advanced Gastric Cancer Using Preoperative 18F-FDG PET/CT

AU - Kwon, Hye Ryeong

AU - Pahk, Kisoo

AU - Park, Sungsoo

AU - Kwon, Hyun Woo

AU - Kim, Sungeun

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Purpose: This study evaluated the usefulness of semiquantitative and volumetric PET parameters for predicting prognosis in patients with advanced gastric cancer (AGC). Methods: We enrolled 213 patients who underwent 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) prior to curative surgery for AGC. Maximum standardized uptake value (SUVmax) and tumor-to-liver uptake ratio (TLR) were measured in all patients. Metabolic tumor volume (MTV) and total lesion glycolysis were measured in volume-measurable patients. For further quantification of FDG uptake, we developed PET prognostic scores by combining SUVmax and MTV (1: low SUVmax/low MTV; 2: high SUVmax/low MTV; 3: high SUVmax/high MTV). Comparison of PET parameters between recurrence and non-recurrence groups was performed. Univariate and multivariate analyses for recurrence-free survival (RFS) and overall survival (OS) were subsequently performed. Results: The recurrence rate was 32.4% (69/213 patients). Mean SUVmax and mean MTV of the recurrence group were significantly higher than those of the non-recurrence group (p = 0.026 and p = 0.025). TLR showed marginal significance (p = 0.051). In multivariate analysis for RFS including all patients, SUVmax (p = 0.022), TLR (p = 0.010), and PET score (p = 0.003) were independent prognostic factors. In post hoc analysis of PET score, significant differences in RFS were observed between PET scores 2 and 3 as well as scores 1 and 3. No significant difference in RFS was observed between scores 1 and 2. Only PET score was statistically significant for OS in univariate analysis. None of the PET parameters were statistically significant for OS in multivariate analysis. Conclusion: High SUVmax and high MTV of the primary tumor suggest a high risk of recurrence for AGC patients. Even if SUVmax is similar, the prognosis may vary depending on MTV. Combining PET parameters results in a better prediction for prognosis.

AB - Purpose: This study evaluated the usefulness of semiquantitative and volumetric PET parameters for predicting prognosis in patients with advanced gastric cancer (AGC). Methods: We enrolled 213 patients who underwent 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) prior to curative surgery for AGC. Maximum standardized uptake value (SUVmax) and tumor-to-liver uptake ratio (TLR) were measured in all patients. Metabolic tumor volume (MTV) and total lesion glycolysis were measured in volume-measurable patients. For further quantification of FDG uptake, we developed PET prognostic scores by combining SUVmax and MTV (1: low SUVmax/low MTV; 2: high SUVmax/low MTV; 3: high SUVmax/high MTV). Comparison of PET parameters between recurrence and non-recurrence groups was performed. Univariate and multivariate analyses for recurrence-free survival (RFS) and overall survival (OS) were subsequently performed. Results: The recurrence rate was 32.4% (69/213 patients). Mean SUVmax and mean MTV of the recurrence group were significantly higher than those of the non-recurrence group (p = 0.026 and p = 0.025). TLR showed marginal significance (p = 0.051). In multivariate analysis for RFS including all patients, SUVmax (p = 0.022), TLR (p = 0.010), and PET score (p = 0.003) were independent prognostic factors. In post hoc analysis of PET score, significant differences in RFS were observed between PET scores 2 and 3 as well as scores 1 and 3. No significant difference in RFS was observed between scores 1 and 2. Only PET score was statistically significant for OS in univariate analysis. None of the PET parameters were statistically significant for OS in multivariate analysis. Conclusion: High SUVmax and high MTV of the primary tumor suggest a high risk of recurrence for AGC patients. Even if SUVmax is similar, the prognosis may vary depending on MTV. Combining PET parameters results in a better prediction for prognosis.

KW - Advanced gastric cancer

KW - FDG PET/CT

KW - Maximum standardized uptake value

KW - Metabolic tumor volume

KW - Recurrence

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DO - 10.1007/s13139-019-00622-w

M3 - Article

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JF - Nuclear Medicine and Molecular Imaging

SN - 1869-3474

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