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Predictive value of pretreatment metabolic activity measured by fluorodeoxyglucose positron emission tomography in patients with metastatic advanced gastric cancer: the maximal SUV of the stomach is a prognostic factor.

Authors
 Jun Chul Park  ;  Jae-Hoon Lee  ;  Kungseok Cheoi  ;  Hyunsoo Chung  ;  Mi Jin Yun  ;  Hyuk Lee  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
Citation
 European Journal of Nuclear Medicine and Molecular Imaging, Vol.39(7) : 1107-1116, 2012 
Journal Title
 European Journal of Nuclear Medicine and Molecular Imaging 
ISSN
 1619-7070 
Issue Date
2012
MeSH
Adenocarcinoma/diagnostic imaging* ; Adenocarcinoma/metabolism* ; Adenocarcinoma/pathology ; Adenocarcinoma/secondary ; Adult ; Aged ; Female ; Fluorodeoxyglucose F18*/pharmacokinetics ; Humans ; Male ; Middle Aged ; Multimodal Imaging ; Neoplasm Metastasis ; Positron-Emission Tomography/methods* ; Predictive Value of Tests ; Prognosis ; Radiopharmaceuticals*/pharmacokinetics ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/metabolism* ; Stomach Neoplasms/pathology ; Tomography, X-Ray Computed ; Young Adult
Keywords
Pretreatment fluorodeoxyglucose uptake ; Advanced gastric cancer ; Maximal SUV ; Chemotherapeutic response ; Prognosis
Abstract
PURPOSE: Few studies have evaluated metabolic activity by (18)F-FDG PET as a prognostic factor in advanced gastric cancer (AGC). We investigated its prognostic role in metastatic AGC. METHODS: We enrolled 82 patients with metastatic AGC, who were treatment-naive and underwent pretreatment (18)F-FDG PET/CT scanning. In each patient, the maximal standardized uptake value (SUVmax) was measured in each target lesion. Stomach(SUVmax) was defined as SUVmax in the stomach, while Total(SUVmax) was defined as the highest SUVmax among all the target lesions. RESULTS: The stomach was the organ most frequently displaying the highest SUVmax among all the target lesions (in 67.1% of patients). A Total(SUVmax) value of 11.5 was the value with the maximum sum of sensitivity and specificity from receiver-operating characteristic curves for progression-free survival (PFS). PFS was significantly longer in patients with a Total(SUVmax) value <11.5 than in those with a Total(SUVmax) value ≥11.5 (P = 0.023); however, overall survival (OS) was not (P = 0.055). A Stomach(SUVmax) value of 6.0 was derived by similar methods. PFS and OS were significantly longer in those with a Stomach(SUVmax) value <6.0 than in those with a Stomach(SUVmax) value ≥6.0 (P = 0.001 and P = 0.006, respectively). Furthermore, those with a low Total(SUVmax) and those with a low Stomach(SUVmax) showed better chemotherapeutic responses (P = 0.016 and P = 0.034, respectively). Among patients with histologically undifferentiated carcinomas, those with lower Total(SUVmax) and those with lower Stomach(SUVmax) showed longer median PFS (P = 0.027 and P = 0.005, respectively) and OS (P = 0.009 and P <0.001, respectively). Multivariate analysis demonstrated Stomach(SUVmax) as an independent predictor of PFS (P = 0.002) and OS (P = 0.038). CONCLUSION: Pretreatment metabolic activity may be a useful prognostic marker in patients with metastatic AGC undergoing palliative chemotherapy. Notably, Stomach(SUVmax) was the single, most robust factor predicting prognosis.
Full Text
http://link.springer.com/article/10.1007%2Fs00259-012-2116-x
DOI
22526958
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Hyuk(이혁)
Cheoi, Kyung Seok(최경석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90214
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