We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Coefficient of Variation in Metastatic Lymph Nodes Determined by 18 F-FDG PET/CT in Patients with Advanced NSCLC: Combination with Coefficient of Variation in Primary Tumors.
- Authors
Pellegrino, Sara; Fonti, Rosa; Vallone, Carlo; Morra, Rocco; Matano, Elide; De Placido, Sabino; Del Vecchio, Silvana
- Abstract
Simple Summary: Lung cancer is the leading cause of cancer-related death worldwide. The 18F-FDG PET/CT scan is used daily for the diagnosis and staging of lung cancer. The heterogeneity of 18F-FDG uptake inside tumor lesions may have prognostic implications for lung cancer patients. Therefore, we tested whether an index of heterogeneity such as the coefficient of variation (CoV), determined in both metastatic lymph nodes and primary tumors, can predict overall survival of lung cancer patients. We found that a combination of CoV of targeted lymph nodes with CoV of primary tumors in each patient provides a more accurate prognostic stratification of lung cancer allowing risk-adapted therapy in individual patients. Purpose The aim of the present study was to test whether the coefficient of variation (CoV) of 18F-FDG PET/CT images of metastatic lymph nodes and primary tumors may predict clinical outcome in patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods Fifty-eight NSCLC patients who had undergone 18F-FDG PET/CT at diagnosis were evaluated. SUVmax, SUVmean, CoV, MTV and TLG were determined in targeted lymph nodes and corresponding primary tumors along with Total MTV (MTVTOT) and Whole-Body TLG (TLGWB) of all malignant lesions. Univariate analysis was performed using Cox proportional hazards regression whereas the Kaplan–Meier method and log-rank tests were used for survival analysis. Results Fifty-eight metastatic lymph nodes were analyzed and average values of SUVmax, SUVmean, CoV, MTV and TLG were 11.89 ± 8.54, 4.85 ± 1.90, 0.37 ± 0.16, 46.16 ± 99.59 mL and 256.84 ± 548.27 g, respectively, whereas in primary tumors they were 11.92 ± 6.21, 5.47 ± 2.34, 0.36 ± 0.14, 48.03 ± 64.45 mL and 285.21 ± 397.95 g, respectively. At univariate analysis, overall survival (OS) was predicted by SUVmax (p = 0.0363), SUVmean (p = 0.0200) and CoV (p = 0.0139) of targeted lymph nodes as well as by CoV of primary tumors (p = 0.0173), MTVTOT (p = 0.0007), TLGWB (p = 0.0129) and stage (p = 0.0122). Using Kaplan–Meier analysis, OS was significantly better in patients with CoV of targeted lymph nodes ≤ 0.29 than those with CoV > 0.29 (p = 0.0147), meanwhile patients with CoV of primary tumors > 0.38 had a better prognosis compared to those with CoV ≤ 0.38 (p = 0.0137). Finally, we combined the CoV values of targeted lymph nodes and primary tumors in all possible arrangements and a statistically significant difference was found among the four survival curves (p = 0.0133). In particular, patients with CoV of targeted lymph nodes ≤ 0.29 and CoV of primary tumors > 0.38 had the best prognosis. Conclusions The CoV of targeted lymph nodes combined with the CoV of primary tumors can predict prognosis of NSCLC patients.
- Subjects
LUNG cancer; STATISTICS; LOG-rank test; LYMPH nodes; METASTASIS; POSITRON emission tomography computed tomography; HEALTH outcome assessment; RADIOPHARMACEUTICALS; KAPLAN-Meier estimator; DEOXY sugars; PROPORTIONAL hazards models; OVERALL survival
- Publication
Cancers, 2024, Vol 16, Issue 2, p279
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16020279