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Quantitative assessment of the asphericity of pretherapeutic FDG uptake as an independent predictor of outcome in NSCLC.

Apostolova I, Rogasch J, Buchert R, Wertzel H, Achenbach HJ, Schreiber J, Riedel S, Furth C, Lougovski A, Schramm G, Hofheinz F, Amthauer H, Steffen IG - BMC Cancer (2014)

Bottom Line: None of the other semi-quantitative PET parameters showed significant predictive value with respect to OAS or PFS.Kaplan-Meier analysis revealed a probability of 2-year PFS of 52% in patients with low ASP compared to 12% in patients with high ASP (p<0.001).The novel parameter asphericity of pretherapeutic FDG uptake seems to provide better prognostic value for PFS and OAS in NCSLC compared to SUV, metabolic tumor volume, total lesion glycolysis and solidity.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, Magdeburg, Germany. Ivayla.apostolova@med.ovgu.de.

ABSTRACT

Background: The aim of the present study was to evaluate the predictive value of a novel quantitative measure for the spatial heterogeneity of FDG uptake, the asphericity (ASP) in patients with non-small cell lung cancer (NSCLC).

Methods: FDG-PET/CT had been performed in 60 patients (15 women, 45 men; median age, 65.5 years) with newly diagnosed NSCLC prior to therapy. The FDG-PET image of the primary tumor was segmented using the ROVER 3D segmentation tool based on thresholding at the volume-reproducing intensity threshold after subtraction of local background. ASP was defined as the relative deviation of the tumor's shape from a sphere. Univariate and multivariate Cox regression as well as Kaplan-Meier (KM) analysis and log-rank test with respect to overall (OAS) and progression-free survival (PFS) were performed for clinical variables, SUVmax/mean, metabolically active tumor volume (MTV), total lesion glycolysis (TLG), ASP and "solidity", another measure of shape irregularity.

Results: ASP, solidity and "primary surgical treatment" were significant independent predictors of PFS in multivariate Cox regression with binarized parameters (HR, 3.66; p<0.001, HR, 2.11; p=0.05 and HR, 2.09; p=0.05), ASP and "primary surgical treatment" of OAS (HR, 3.19; p=0.02 and HR, 3.78; p=0.01, respectively). None of the other semi-quantitative PET parameters showed significant predictive value with respect to OAS or PFS. Kaplan-Meier analysis revealed a probability of 2-year PFS of 52% in patients with low ASP compared to 12% in patients with high ASP (p<0.001). Furthermore, it showed a higher OAS rate in the case of low versus high ASP (1-year-OAS, 91% vs. 67%: p=0.02).

Conclusions: The novel parameter asphericity of pretherapeutic FDG uptake seems to provide better prognostic value for PFS and OAS in NCSLC compared to SUV, metabolic tumor volume, total lesion glycolysis and solidity.

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Related in: MedlinePlus

Correlations between ASP and MTV (A), ASP and SUVmax (B) and TLG and MTV (C), solidity and MTV (D), solidity and SUVmax (E), solidity and ASP (F).
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Fig2: Correlations between ASP and MTV (A), ASP and SUVmax (B) and TLG and MTV (C), solidity and MTV (D), solidity and SUVmax (E), solidity and ASP (F).

Mentions: Descriptive values of SUVmax, SUVmean, MTV, TLG, ASP and solidity are given in Table 2. TLG and MTV were strongly correlated (rho = 0.96, p < 0.001). There was a moderate correlation between ASP and MTV (rho = 0.54, p < 0.001) and no significant correlation between ASP and SUVmax (Figure 2, A-B). Solidity was significantly inversely correlated with ASP (rho = -0.79, p < 0.001) but not with SUVmax and MTV (Figure 2, D-F)Table 2


Quantitative assessment of the asphericity of pretherapeutic FDG uptake as an independent predictor of outcome in NSCLC.

Apostolova I, Rogasch J, Buchert R, Wertzel H, Achenbach HJ, Schreiber J, Riedel S, Furth C, Lougovski A, Schramm G, Hofheinz F, Amthauer H, Steffen IG - BMC Cancer (2014)

Correlations between ASP and MTV (A), ASP and SUVmax (B) and TLG and MTV (C), solidity and MTV (D), solidity and SUVmax (E), solidity and ASP (F).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4265451&req=5

Fig2: Correlations between ASP and MTV (A), ASP and SUVmax (B) and TLG and MTV (C), solidity and MTV (D), solidity and SUVmax (E), solidity and ASP (F).
Mentions: Descriptive values of SUVmax, SUVmean, MTV, TLG, ASP and solidity are given in Table 2. TLG and MTV were strongly correlated (rho = 0.96, p < 0.001). There was a moderate correlation between ASP and MTV (rho = 0.54, p < 0.001) and no significant correlation between ASP and SUVmax (Figure 2, A-B). Solidity was significantly inversely correlated with ASP (rho = -0.79, p < 0.001) but not with SUVmax and MTV (Figure 2, D-F)Table 2

Bottom Line: None of the other semi-quantitative PET parameters showed significant predictive value with respect to OAS or PFS.Kaplan-Meier analysis revealed a probability of 2-year PFS of 52% in patients with low ASP compared to 12% in patients with high ASP (p<0.001).The novel parameter asphericity of pretherapeutic FDG uptake seems to provide better prognostic value for PFS and OAS in NCSLC compared to SUV, metabolic tumor volume, total lesion glycolysis and solidity.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Radiology and Nuclear Medicine, University Hospital, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, Magdeburg, Germany. Ivayla.apostolova@med.ovgu.de.

ABSTRACT

Background: The aim of the present study was to evaluate the predictive value of a novel quantitative measure for the spatial heterogeneity of FDG uptake, the asphericity (ASP) in patients with non-small cell lung cancer (NSCLC).

Methods: FDG-PET/CT had been performed in 60 patients (15 women, 45 men; median age, 65.5 years) with newly diagnosed NSCLC prior to therapy. The FDG-PET image of the primary tumor was segmented using the ROVER 3D segmentation tool based on thresholding at the volume-reproducing intensity threshold after subtraction of local background. ASP was defined as the relative deviation of the tumor's shape from a sphere. Univariate and multivariate Cox regression as well as Kaplan-Meier (KM) analysis and log-rank test with respect to overall (OAS) and progression-free survival (PFS) were performed for clinical variables, SUVmax/mean, metabolically active tumor volume (MTV), total lesion glycolysis (TLG), ASP and "solidity", another measure of shape irregularity.

Results: ASP, solidity and "primary surgical treatment" were significant independent predictors of PFS in multivariate Cox regression with binarized parameters (HR, 3.66; p<0.001, HR, 2.11; p=0.05 and HR, 2.09; p=0.05), ASP and "primary surgical treatment" of OAS (HR, 3.19; p=0.02 and HR, 3.78; p=0.01, respectively). None of the other semi-quantitative PET parameters showed significant predictive value with respect to OAS or PFS. Kaplan-Meier analysis revealed a probability of 2-year PFS of 52% in patients with low ASP compared to 12% in patients with high ASP (p<0.001). Furthermore, it showed a higher OAS rate in the case of low versus high ASP (1-year-OAS, 91% vs. 67%: p=0.02).

Conclusions: The novel parameter asphericity of pretherapeutic FDG uptake seems to provide better prognostic value for PFS and OAS in NCSLC compared to SUV, metabolic tumor volume, total lesion glycolysis and solidity.

Show MeSH
Related in: MedlinePlus