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Prognostic Value of Pretreatment Metabolic Tumor Volume and Total Lesion Glycolysis Using 18F-FDG PET/CT in Patients With Metastatic Renal Cell Carcinoma Treated With Anti-Vascular Endothelial Growth Factor-Targeted Agents.

Authors
 Sang Hyun Hwang  ;  Arthur Cho  ;  Mijin Yun  ;  Young Deuk Choi  ;  Sun Young Rha  ;  Won Jun Kang 
Citation
 Clinical Nuclear Medicine, Vol.42(5) : 235-241, 2017 
Journal Title
 Clinical Nuclear Medicine 
ISSN
 0363-9762 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell/diagnostic imaging* ; Carcinoma, Renal Cell/drug therapy ; Female ; Fluorodeoxyglucose F18* ; Glycolysis* ; Humans ; Indoles/therapeutic use ; Kidney Neoplasms/diagnostic imaging* ; Kidney Neoplasms/drug therapy ; Male ; Middle Aged ; Niacinamide/analogs & derivatives ; Niacinamide/therapeutic use ; Phenylurea Compounds/therapeutic use ; Positron Emission Tomography Computed Tomography* ; Pyrimidines/therapeutic use ; Pyrroles/therapeutic use ; Radiopharmaceuticals* ; Sulfonamides/therapeutic use
Keywords
F-FDG PET ; metabolic tumor volume ; metastatic renal cell carcinoma ; prognosis ; total lesion glycolysis
Abstract
PURPOSE: The aim of this study was to evaluate the prognostic value of pretreatment metabolic tumor volume (MTV) and total lesion glycolysis (TLG) using F-FDG PET/CT in patients with metastatic renal cell carcinoma (RCC) after treatment with anti-vascular endothelial growth factor-targeted agents. METHODS: Fifty-six patients with metastatic RCC who underwent F-FDG PET/CT for staging and recurrence evaluation were retrospectively enrolled. SUVmax, MTV, and TLG were measured using F-FDG PET/CT in all patients. The highest SUV in all the metastatic RCC lesions of each patient was defined as SUVmax. Metabolic tumor volume was defined as the total tumor volume greater than 40% of SUVmax. Total lesion glycolysis was calculated as (MTV) · (SUVmean). The prognostic significance of PET/CT parameters and clinical factors for progression-free survival (PFS) and overall survival (OS) were evaluated by univariate and multivariate analyses, along with other clinical factors. RESULTS: The most common organ for metastases was lung (35 patients). In the univariate analysis, hypercalcemia, time from diagnosis to treatment, SUVmax, MTV, and TLG were significant prognostic factors affecting PFS (P < 0.05), and Karnofsky score, hypercalcemia, time from diagnosis to treatment, SUVmax, MTV, and TLG were significant prognostic factors affecting OS (P < 0.05). In the multivariate analysis, hypercalcemia, MTV, and TLG were independent prognostic factors affecting PFS (P < 0.05), and hypercalcemia, time from diagnosis to treatment, MTV, and TLG were independent prognostic factors affecting OS (P < 0.05). In subgroup analyses, the high MTV or TLG groups showed poor prognosis for PFS and OS in patients with intermediate or poor risk. CONCLUSIONS: Metabolic tumor volume and TLG are independent prognostic factors for predicting PFS and OS in patients with metastatic RCC. Furthermore, MTV and TLG could provide additional prognostic information in patients with clinically high-risk metastatic RCC treated with anti-vascular endothelial growth factor-targeted therapies.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00003072-201705000-00028&D=ovft&PDF=y
DOI
10.1097/RLU.0000000000001612.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강원준(Kang, Won Jun) ORCID logo https://orcid.org/0000-0002-2107-8160
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
조응혁(Cho, Arthur Eung Hyuck) ORCID logo https://orcid.org/0000-0001-8670-2473
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/153844
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