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FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients

E Incerti1, S Broggi2, A Fodor3

  • 1Unit of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.

European Journal of Nuclear Medicine and Molecular Imaging
|June 8, 2018
PubMed
Abstract

Insights

Fluorodeoxyglucose (FDG) PET-derived parameters effectively predict survival outcomes in malignant pleural mesothelioma (MPM) patients undergoing salvage helical tomotherapy (HTT). These metrics can help identify patients with poorer prognoses for targeted treatment selection.

Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiotherapy

Background:

  • Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited treatment options.
  • Salvage helical tomotherapy (HTT) is used in previously treated MPM patients.
  • Predictive biomarkers are needed to optimize treatment selection for MPM.

Purpose of the Study:

  • To evaluate the prognostic value of FDG PET-derived parameters for overall survival (OS), local relapse-free survival (LRFS), and distant relapse-free survival (DRFS) in MPM patients.
  • To identify optimal FDG PET parameters for predicting survival in MPM patients treated with salvage HTT.

Main Methods:

  • Retrospective analysis of 55 MPM patients treated with FDG PET/CT-guided salvage HTT.
  • Assessment of FDG PET-derived parameters including biological target volume (BTV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) at various uptake thresholds.
  • Univariate and logistic regression analyses were performed to determine predictive significance for survival outcomes.

Main Results:

  • BTV and TLG (at 40%, 50%, 60% thresholds) were significant predictors of OS (p < 0.005).
  • Higher MTV and TLG values were associated with significantly shorter median OS, LRFS, and DRFS.
  • BTV, TLG40, and MTV40 effectively predicted poor OS, LRFS, and DRFS.

Conclusions:

  • FDG PET-derived parameters, particularly BTV and TLG, demonstrate significant prognostic value in MPM patients.
  • These quantitative PET metrics can effectively discriminate patients with poor survival outcomes.
  • FDG PET parameters may aid in selecting MPM patients who would benefit from salvage HTT.
Keywords:
FDG PET/CTHelical tomotherapyMTVMalignant pleural mesotheliomaSurvivalTLG

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