The role of 18F-fluorodeoxyglucose uptake of bone marrow on PET/CT in predicting clinical outcomes in non-small cell lung cancer patients treated with chemoradiotherapy
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This study aimed to assess the relationship between bone marrow (BM) FDG uptake on PET/CT and serum inflammatory markers and to evaluate the prognostic value of BM FDG uptake for predicting clinical outcomes in non-small cell lung cancer (NSCLC) patients.
One hundred and six NSCLC patients who underwent FDG PET/CT for staging work-up and received chemoradiotherapy were enrolled. Mean BM FDG uptake (BM SUV) and BM-to-liver uptake ratio (BLR) were measured, along with volumetric parameters of PET/CT. The relationship of BM SUV and BLR with hematologic parameters and serum inflammatory markers was evaluated. Prognostic values of BM SUV and BLR for predicting progression-free survival (PFS) and overall survival (OS) were assessed.
BM SUV and BLR were significantly correlated with white blood cell count and C-reactive protein level. On univariate analysis, BLR was a significant prognostic factor for both PFS and OS. On multivariate analysis, TNM stage and BLR were independent prognostic factors for PFS, and only TNM stage was an independent prognostic factor for OS.
In NSCLC patients, FDG uptake of BM reflects the systemic inflammatory response and can be used as a biomarker to identify patients with poor prognosis.
• Bone marrow FDG uptake is correlated with serum inflammatory markers.
• Bone marrow FDG uptake is an independent prognostic factor for progression-free survival.
• Bone marrow FDG uptake can provide information on predicting lung cancer progression.
KeywordsLung cancer Prognosis Positron emission tomography FDG Bone marrow
Abbreviations and acronyms
Non-small cell lung cancer
Standardized uptake value
Maximum SUV of tumour
Metabolic tumour volume
Total lesion glycolysis
Bone marrow-to-liver uptake ratio of SUV
White blood cell
This work was supported in part by the Soonchunhyang University Research Fund, and by the research fund of Catholic Kwandong University International St. Mary’s Hospital (CKURF-201601650001). The scientific guarantor of this publication is Sang Mi Lee, M.D., Ph.D. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: Retrospective prognostic study performed at one institution
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