Korean J Radiol.  2013 Feb;14(1):1-12. 10.3348/kjr.2013.14.1.1.

Prognostic Significance of Volume-Based PET Parameters in Cancer Patients

Affiliations
  • 1Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. jynm.choi@samsung.com

Abstract

Accurate prediction of cancer prognosis before the start of treatment is important since these predictions often affect the choice of treatment. Prognosis is usually based on anatomical staging and other clinical factors. However, the conventional system is not sufficient to accurately and reliably determine prognosis. Metabolic parameters measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) have the potential to provide valuable information regarding prognosis and treatment response evaluation in cancer patients. Among these parameters, volume-based PET parameters such as metabolic tumor volume and total lesion glycolysis are especially promising. However, the measurement of these parameters is significantly affected by the imaging methodology and specific image characteristics, and a standard method for these parameters has not been established. This review introduces volume-based PET parameters as potential prognostic indicators, and highlights methodological considerations for measurement, potential implications, and prospects for further studies.

Keyword

Positron emission tomography; 18F-fluorodeoxyglucose; Metabolic tumor volume; Total lesion glycolysis; Prognosisrinogenesis

MeSH Terms

Fluorodeoxyglucose F18/diagnostic use
Glycolysis
Humans
Neoplasm Staging
Neoplasms/pathology/*radionuclide imaging
*Positron-Emission Tomography
Predictive Value of Tests
Prognosis
Radiopharmaceuticals/diagnostic use
Tumor Burden

Figure

  • Fig. 1 Measurement of metabolic tumor volume in patients with esophageal cancer. 18F-fluorodeoxyglucose PET/CT images of 53-year-old male patient with esophageal cancer demonstrating measurement of metabolic tumor volume. Boundary of metabolically active tumor was automatically delineated using isocontour, defined as percentage of maximum SUV in tumor (40% in this image). VOI = volume of interest, SUV = standardized uptake values

  • Fig. 2 Kaplan-Meier survival curves for overall survival using MTV (A), TLG (B), and SUVmax (C) in 69 patients with squamous cell carcinoma of tonsil. MTV = metabolic tumor volume, TLG = total lesion glycolysis, SUVmax = maximum standardized uptake value


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