Prognostic value of metabolic tumor volume of pretreatment (18)F-FAMT PET/CT in non-small cell lung Cancer

BACKGROUND: This study aimed to determine the prognostic value of positron emission tomography (PET) metabolic parameters—namely metabolic tumor volume (MTV), total lesion glycolysis (TLG), and total lesion retention (TLR)—on fluorine-18 ((18)F) fluorodeoxyglucose (FDG) and L- [3-(18)F]-α-methyltyrosine ((18)F-FAMT) PET/CT in patients with non-small-cell lung cancer (NSCLC). METHODS: The study group comprised 112 NSCLC patients who underwent (18)F-FDG and (18)F-FAMT PET/CT prior to any therapy. The MTV, TLG, TLR, and maximum standardized uptake value (SUV(max)) of the primary tumors were determined. Automatic MTV measurement was performed using PET volume computer assisted reading software. (GE Healthcare). Cox proportional hazards models were built to assess the prognostic value of MTV, TLG (for (18)F-FDG), TLR (for (18)F-FAMT), SUV(max), T stage, N stage, M stage, clinical stage, age, sex, tumor histological subtype, and treatment method (surgery or other therapy) on overall survival (OS). RESULTS: Higher TNM, higher clinical stage, inoperable status, and higher values for all PET parameters (both (18)F-FAMT and (18)F-FDG PET) were significantly associated (P < 0.05) with shorter OS. Multivariate analysis revealed that a higher MTV of (18)F-FAMT (hazard ratio [HR]: 2.88, CI: 1.63–5.09, P < 0.01) and advanced clinical stage (HR: 5.36, CI: 1.88–15.34, P < 0.01) were significant predictors of shorter OS. CONCLUSIONS: MTV of (18)F-FAMT is of prognostic value for OS in NSCLC cases and can help guide decision-making during patient management.