Prognostic Value of Dual-Time-Point [18F]FDG PET/CT for Predicting Distant Metastasis after Treatment in Patients with Non-Small Cell Lung Cancer

This study aimed to evaluate the prognostic significance of 2-Deoxy-2-[F-18]fluoro-D-glucose ([F-18]FDG) uptake in the bone marrow (BM) and primary tumors on dual-time-point (DTP) PET/CT for predicting progression-free survival (PFS) and distant metastasis-free survival (DMFS) in patients with non-small cell lung cancer (NSCLC). We retrospectively analyzed DTP [F-18]FDG PET/CT images from 211 patients with NSCLC. The maximum standardized uptake value (SUV) of primary lung cancer and mean [F-18]FDG uptake of the BM (BM SUV) were measured from early and delayed PET/CT images, and the percent changes in these parameters (Delta maximum SUV and Delta BM SUV) were calculated. On multivariate survival analysis, the maximum SUV and BM SUV on both early and delayed PET/CT scans were significantly associated with PFS, while the Delta maximum SUV and Delta BM SUV failed to show statistical significance. For DMFS, the Delta maximum SUV and Delta BM SUV were independent predictors along with the TNM stage. Distant progression was observed only in 1.3% of patients with low Delta maximum SUV and Delta BM SUV, whereas 28.2% of patients with high Delta maximum SUV and Delta BM SUV experienced distant progression. The Delta maximum SUV and Delta BM SUV on DTP [F-18]FDG PET/CT were significant independent predictors for DMFS in patients with NSCLC.