The prognostic significance of metabolic tumor volume (mtv) and total lesion glycolysis (TLG) with F18 FDG PET/CT in non-small cell lung cancer (NSCLC)

The prognostic significance of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) with F18 FDG PET/CT in non-small cell lung cancer (NSCLC) Purpose: To investigate the relationship between the semi-quantitative parameters such as SUVmax, MTV and TLG and the stage of disease and histological subtype and contribution of these parameters to prediction of prognosis in NSCLC. Materials and Methods: A total of 102 patients with the diagnosis of NSCLC and underwent PET/CT imaging for staging were included in the study. Histopathological diagnosis, stage of the disease, SUVmax-MTV-TLG values of mass lesions and date of diagnosis were recorded. Survival times of the patients were determined by phone calls to all patients. Findings: 71 patients had a pathological diagnosis of squamous cell carcinoma (69.61%) and 31 patients had adenocarcinoma (30.39%). When the relationship between TNM stage of the disease and survival was examined, survival times were shorter in patients with advanced stage (p=0.002). Statistically significant negative correlation was determined between MTV and survival (p=0.020) and TLG and survival (p=0.027). No statistically significant relationships between SUVmax and survival (p=0.861) and SUVmax and stage of the disease (p=0.473) have been determined. Mean MTV value was 22.32 in stage 1,2 and 68.2 in stage 3,4 (p=0.012); the mean TLG value was calculated as 232.27 in stage 1,2 and 569.69 (p=0.037) in stage 3,4. As the stage increased, MTV and TLG increased and survival time decreased. There was no significant relationship between the MTV-TLG and histopathological types of the lesions. SUVmax values were higher in SCC. Conclusion: MTV and TLG of FDG PET/CT contribute significantly in predicting survival and prognosis in non-small cell lung cancers independently from stage and histopathological subtype. Key words: Lung Cancer, FDG PET/CT, prognosis, SUVmax, MTV, TLG