The Prognostic Value of 18F-Fluorodeoxyglucose Uptake by Using Serial Positron Emission Tomography and Computed Tomography in Patients With Stage III Nonsmall Cell Lung Cancer

Objectives: To determine the prognostic value of standardized uptake value (SUV) of F-18-fluorodeoxyglucose by serial positron emission tomography and computed tomography (PET/CT) in non-small cell lung cancer (NSCLC). Methods: Forty-seven patients (37 male, 10 female) with NSCLC in stage III were enrolled. All patients had at least 2 serial F-18-fluorodeoxyglucose PET/CT scans, both before and after therapy, and the maximum standardized uptake value (SUVmax) of the primary lung lesion was calculated. The value changes of SUVmax before and after treatment were calculated according to the following equation: Delta SUV = (SUVbefore - SUVafter) x 100%/SUVbefore. Results: Of the 47 eligible patients, after a median follow-up of 23.5 months (range, 13-34 months), 26 patients had local and regional recurrence or metastasis and 21 remained disease-free. Significant differences in SUVmax were observed either before (P-1 = 0.003) or after (P-2 = 0.002) treatment between the 2 groups. However, the percent change of SUVmax were observed either before (P-1 = 0.03) or after (P-2 = 0.02) treatment between the 2 groups. However, the percent change of SUVmax before and after therapy were not significantly different (P = 0.054). Conclusions: SUV from 2 serial PET/CT scans, before and after concurrent chemoradiotherapy were significant predictors for local and regional recurrence or metastasis. SUV is a significant predictor for local and regional recurrence or metastasis in patients of NSCLC.