Vol 26, No 3 (2021)
Research paper
Published online: 2021-03-30

open access

Page views 626
Article views/downloads 494
Get Citation

Connect on Social Media

Connect on Social Media

Differences between TNM classification and 2-[18F]FDG PET parameters of primary tumor in NSCLC patients

Paulina Cegla1, Maciej Bryl2, Kamila Witkowska3, Agnieszka Bos-Liedke4, Katarzyna Pietrasz1, Witold Kycler56, Julian Malicki78, Tomasz Piotrowski78, Rafał Czepczyński39
Rep Pract Oncol Radiother 2021;26(3):445-450.

Abstract

BACKGROUND: The aim of the study was to compare the TNM classification with 2-[18F]FDG PET biological parameters of primary tumor in patients with NSCLC.

MATERIALS AND METHODS: Retrospective analysis was performed on a group of 79 newly diagnosed NSCLC patients. PET scans were acquired on Gemini TF PET/CT scanner 60–70 min after injection of 2-[18F]FDG with the mean activity of 364 ± 75 MBq, with the area being examined from the vertex to mid-thigh. The reconstructed PET images were evaluated using MIM 7.0 Software for SUVmax, MTV and TLG values.

RESULTS: The analysis of the cancer stage according to TNM 8th edition showed stage IA2 in 8 patients, stage IA3 — 6 patients, stage IB — 4 patients, IIA — 3 patients, 15 patients with stage IIB, stage IIIA — 17 patients, IIIB — 5, IIIC — 5, IVA in 7 patients and stage IVB in 9 patients. The lowest TLG values of primary tumor were observed in stage IA2 (11.31 ± 15.27) and the highest in stage IIIC (1003.20 ± 953.59). The lowest value of primary tumor in SUVmax and MTV were found in stage IA2 (6.8 ± 3.8 and 1.37 ± 0.42, respectively), while the highest SUVmax of primary tumor was found in stage IIA (13.4 ± 11.4) and MTV in stage IIIC (108.15 ± 127.24).

CONCLUSION: TNM stages are characterized by different primary tumor 2-[18F]FDG PET parameters, which might complement patient outcome.

Article available in PDF format

View PDF Download PDF file

References

  1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
  2. Didkowska J, Wojciechowska U, Mańczuk M, et al. Lung cancer epidemiology: contemporary and future challenges worldwide. Ann Transl Med. 2016; 4(8): 150.
  3. Opoka L, Kunikowska J, Podgajny Z, et al. Staging of non-small cell lung cancer using CT and integrated PET-CT. Pneumonol Alergol Pol. 2013; 81(5).
  4. Dela Cruz CS, Tanoue LT, Matthay RA. Lung cancer: epidemiology, etiology, and prevention. Clin Chest Med. 2011; 32(4): 605–644.
  5. Krzakowski M, Jassem J, Antczak A, et al. Cancer of the lung pleura and mediastinum. Oncol Clin Pract. 2019; 15.
  6. Dong M, Liu J, Sun X, et al. Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis. PLoS One. 2016; 11(1): e0146195–659.
  7. Im HJ, Pak K, Cheon GiJ, et al. Prognostic value of volumetric parameters of (18)F-FDG PET in non-small-cell lung cancer: a meta-analysis. Eur J Nucl Med Mol Imaging. 2015; 42(2): 241–251.
  8. Park SY, Cho A, Yu WS, et al. Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer. J Nucl Med. 2015; 56(1): 45–49.
  9. Wrona A, Jassem J. The new TNM classification in lung cancer [in Polish]. Onkol Prak Klin. 2009; 5: 250–260.
  10. Detterbeck FC, Boffa DJ, Kim AW, et al. The Eighth Edition Lung Cancer Stage Classification. Chest. 2017; 151(1): 193–203.
  11. Cegła P, Burchardt E, Wierzchosławska E, et al. The effect of different segmentation methods on primary tumour metabolic volume assessed in F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning. Contemp Oncol (Pozn). 2019; 23(3): 183–186.
  12. Larson SM, Erdi Y, Akhurst T, et al. Tumor Treatment Response Based on Visual and Quantitative Changes in Global Tumor Glycolysis Using PET-FDG Imaging. The Visual Response Score and the Change in Total Lesion Glycolysis. Clin Positron Imaging. 1999; 2(3): 159–171.
  13. Obara P, Liu H, Wroblewski K, et al. Prognostic value of metabolic tumor burden in lung cancer. Chin J Cancer Res. 2013; 25(6): 615–622.
  14. Cegla P, Urbanski B, Burchardt E, et al. Influence of 18F-FDG-PET/CT on staging of cervical cancer. Nuklearmedizin. 2019; 58(1): 17–22.
  15. Lozano Ruiz FJ, Ileana Pérez Álvarez S, Poitevin Chacón MA, et al. The importance of image guided radiotherapy in small cell lung cancer: Case report and review of literature. Rep Pract Oncol Radiother. 2020; 25(1): 146–149.
  16. Chao F, Zhang H. PET/CT in the staging of the non-small-cell lung cancer. J Biomed Biotechnol. 2012; 2012: 783739.
  17. Mirpour S, Mhlanga JC, Logeswaran P, et al. The role of PET/CT in the management of cervical cancer. AJR Am J Roentgenol. 2013; 201(2): W192–W205.
  18. Sugawara Y, Zasadny KR, Neuhoff AW, et al. Reevaluation of the standardized uptake value for FDG: variations with body weight and methods for correction. Radiology. 1999; 213(2): 521–525.
  19. Zhang H, Wroblewski K, Pu Y. Prognostic value of tumor burden measurement using the number of tumors in non-surgical patients with non-small cell lung cancer. Acta Radiol. 2012; 53(5): 561–568.
  20. Daisne JF, Duprez T, Weynand B, et al. Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen. Radiology. 2004; 233(1): 93–100.
  21. Liao S, Penney BC, Wroblewski K, et al. Prognostic value of metabolic tumor burden on 18F-FDG PET in nonsurgical patients with non-small cell lung cancer. Eur J Nucl Med Mol Imaging. 2012; 39(1): 27–38.
  22. Liao S, Penney BC, Zhang H, et al. Prognostic value of the quantitative metabolic volumetric measurement on 18F-FDG PET/CT in Stage IV nonsurgical small-cell lung cancer. Acad Radiol. 2012; 19(1): 69–77.
  23. Kim K, Kim SJ, Kim IJ, et al. Prognostic value of volumetric parameters measured by F-18 FDG PET/CT in surgically resected non-small-cell lung cancer. Nucl Med Commun. 2012; 33(6): 613–620.



Reports of Practical Oncology and Radiotherapy