TY - JOUR
T1 - Noninvasive evaluation of microscopic tumor extensions using standardized uptake value and metabolic tumor volume in non-small-cell lung cancer
AU - Meng, Xue
AU - Sun, Xindong
AU - Mu, Dianbin
AU - Xing, Ligang
AU - Ma, Li
AU - Zhang, Baijiang
AU - Zhao, Shuqiang
AU - Yang, Guoren
AU - Kong, Feng Ming
AU - Yu, Jinming
N1 - Funding Information:
Supported in part by the Research Fund of China National 863 program (No. 2007AA02Z437 )
PY - 2012/2/1
Y1 - 2012/2/1
N2 - Purpose: To prospectively evaluate whether maximal microscopic extensions (MEmax) correlate with maximal standardized uptake value (SUVmax) and metabolic tumor volume (MTV) at 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images in non-small-cell lung cancer (NSCLC). Methods and Materials: Thirty-nine patients with Stage I-IIIA NSCLC underwent surgery after FDG-PET/CT scanning. SUVmax and MTV were calculated on the PET/CT images. The maximum linear distance from the tumor margin to the farthest extent of the tumor in every dimension was measured at the tumor section. The correlations among MEmax, SUVmax, MTV and other clinical pathologic parameters were analyzed. Results: MEmax for all patients had a significant correlation with SUVmax (r = 0.777, p = 0.008) and MTV (r = 0.724, p < 0.001). When expressed in terms of the probability of covering ME with respect to a given margin, we suggested that margins of 1.93 mm, 3.90 mm, and 9.60 mm for SUVmax ≤5, 5-10, and >10 added to the gross tumor volume would be adequate to cover 95% of ME. Conclusions: This study demonstrated that tumors with high SUVmax and MTV have more MEmax and would therefore require more margin expansion from gross tumor volume to clinical target volume. FDG-PET/CT, especially for SUVmax, is promising and effective and merits additional study in noninvasive delimiting of the clinical target volume margin for NSCLC.
AB - Purpose: To prospectively evaluate whether maximal microscopic extensions (MEmax) correlate with maximal standardized uptake value (SUVmax) and metabolic tumor volume (MTV) at 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images in non-small-cell lung cancer (NSCLC). Methods and Materials: Thirty-nine patients with Stage I-IIIA NSCLC underwent surgery after FDG-PET/CT scanning. SUVmax and MTV were calculated on the PET/CT images. The maximum linear distance from the tumor margin to the farthest extent of the tumor in every dimension was measured at the tumor section. The correlations among MEmax, SUVmax, MTV and other clinical pathologic parameters were analyzed. Results: MEmax for all patients had a significant correlation with SUVmax (r = 0.777, p = 0.008) and MTV (r = 0.724, p < 0.001). When expressed in terms of the probability of covering ME with respect to a given margin, we suggested that margins of 1.93 mm, 3.90 mm, and 9.60 mm for SUVmax ≤5, 5-10, and >10 added to the gross tumor volume would be adequate to cover 95% of ME. Conclusions: This study demonstrated that tumors with high SUVmax and MTV have more MEmax and would therefore require more margin expansion from gross tumor volume to clinical target volume. FDG-PET/CT, especially for SUVmax, is promising and effective and merits additional study in noninvasive delimiting of the clinical target volume margin for NSCLC.
KW - Clinical target volume margin
KW - Metabolic tumor volume
KW - Non-small-cell lung cancer
KW - Positron emission tomography/computed tomography
KW - Standardized uptake value
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U2 - 10.1016/j.ijrobp.2010.10.064
DO - 10.1016/j.ijrobp.2010.10.064
M3 - Article
C2 - 21440998
AN - SCOPUS:84855823663
SN - 0360-3016
VL - 82
SP - 960
EP - 966
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 2
ER -