Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions
Abstract Background Although many well-known factors affect the maximum standardized uptake value (SUVmax), it remains the most requested and used parameter, especially among clinicians, despite other parameters, such as the standardized uptake value corrected for lean body mass and the metabolic tu...
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BMC
2024-11-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-024-00807-3 |
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| author | Cristiano Pini Margarita Kirienko Fabrizia Gelardi Paola Bossi Daoud Rahal Luca Toschi Gaia Ninatti Marcello Rodari Giuseppe Marulli Lidija Antunovic Arturo Chiti Emanuele Voulaz Martina Sollini |
| author_facet | Cristiano Pini Margarita Kirienko Fabrizia Gelardi Paola Bossi Daoud Rahal Luca Toschi Gaia Ninatti Marcello Rodari Giuseppe Marulli Lidija Antunovic Arturo Chiti Emanuele Voulaz Martina Sollini |
| author_sort | Cristiano Pini |
| collection | DOAJ |
| description | Abstract Background Although many well-known factors affect the maximum standardized uptake value (SUVmax), it remains the most requested and used parameter, especially among clinicians, despite other parameters, such as the standardized uptake value corrected for lean body mass and the metabolic tumor volume, being proven to be less sensitive to the same factors, more robust, and eventually more informative. This study intends to provide robust evidence regarding the diagnostic and prognostic value of SUVmax in a large cohort of subjects with suspected malignant lung nodules imaged by [18F]FDG PET/CT. Materials and methods We performed a retrospective analysis of patients with suspected/confirmed primary lung tumours undergoing [18F]FDG PET/CT. The sample size was 567 patients. Demographics, imaging, surgical, histological, and follow-up data were collected. SUVmax was analysed according to histology, stage, scanner, and outcome. The impact on measured values of different reconstruction protocols was assessed. All potential predictors of patients’ outcome were assessed. Results 91% cases were primary lung tumours. Lung benign nodules or metastases accounted for 5% and 4% of cases. Most patients presented with adenocarcinoma (70%) and stage I disease (51%); 144 patients relapsed and 55 died. SUVmax failed to effectively differentiate benign lesions from primary tumours or metastases. Stage I patients presented lower SUVmax. SUVmax significantly correlated with patient weight, injected [18F]FDG activity, and lesion size and differed between reconstructions’ protocols. Survival analyses revealed no independent prognostic significance for SUVmax in progression-free after adjusting for other variables. SUVmax correlated with overall survival, disease stage and tumour histotype. Conclusion Our study confirms that SUVmax, though widely employed, present relevant limitations in discriminating between benign lesion and lung cancer, in classifying cancer histotypes, and in predicting patient outcomes independently. Known influencing factors significantly impact on numerical values, thus SUV values should be regarded with caution in clinical practice. |
| format | Article |
| id | doaj-art-e07cd9b1f63849a9a863d77aaaba5a44 |
| institution | Kabale University |
| issn | 1470-7330 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj-art-e07cd9b1f63849a9a863d77aaaba5a442024-12-01T12:42:52ZengBMCCancer Imaging1470-73302024-11-0124111210.1186/s40644-024-00807-3Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesionsCristiano Pini0Margarita Kirienko1Fabrizia Gelardi2Paola Bossi3Daoud Rahal4Luca Toschi5Gaia Ninatti6Marcello Rodari7Giuseppe Marulli8Lidija Antunovic9Arturo Chiti10Emanuele Voulaz11Martina Sollini12Nuclear Medicine, IRCCS San Raffaele HospitalFondazione IRCCS Istituto Nazionale Dei TumoriDepartment of Biomedical Sciences, Humanitas UniversityDepartment of Pathology, IRCCS Humanitas Research HospitalDepartment of Pathology, IRCCS Humanitas Research HospitalMedical Oncology and Haematology Unit, IRCCS Humanitas Research HospitalNuclear Medicine, IRCCS San Raffaele HospitalNuclear Medicine Unit, IRCCS Humanitas Research HospitalDepartment of Biomedical Sciences, Humanitas UniversityNuclear Medicine, IRCCS San Raffaele HospitalNuclear Medicine, IRCCS San Raffaele HospitalDepartment of Biomedical Sciences, Humanitas UniversityNuclear Medicine, IRCCS San Raffaele HospitalAbstract Background Although many well-known factors affect the maximum standardized uptake value (SUVmax), it remains the most requested and used parameter, especially among clinicians, despite other parameters, such as the standardized uptake value corrected for lean body mass and the metabolic tumor volume, being proven to be less sensitive to the same factors, more robust, and eventually more informative. This study intends to provide robust evidence regarding the diagnostic and prognostic value of SUVmax in a large cohort of subjects with suspected malignant lung nodules imaged by [18F]FDG PET/CT. Materials and methods We performed a retrospective analysis of patients with suspected/confirmed primary lung tumours undergoing [18F]FDG PET/CT. The sample size was 567 patients. Demographics, imaging, surgical, histological, and follow-up data were collected. SUVmax was analysed according to histology, stage, scanner, and outcome. The impact on measured values of different reconstruction protocols was assessed. All potential predictors of patients’ outcome were assessed. Results 91% cases were primary lung tumours. Lung benign nodules or metastases accounted for 5% and 4% of cases. Most patients presented with adenocarcinoma (70%) and stage I disease (51%); 144 patients relapsed and 55 died. SUVmax failed to effectively differentiate benign lesions from primary tumours or metastases. Stage I patients presented lower SUVmax. SUVmax significantly correlated with patient weight, injected [18F]FDG activity, and lesion size and differed between reconstructions’ protocols. Survival analyses revealed no independent prognostic significance for SUVmax in progression-free after adjusting for other variables. SUVmax correlated with overall survival, disease stage and tumour histotype. Conclusion Our study confirms that SUVmax, though widely employed, present relevant limitations in discriminating between benign lesion and lung cancer, in classifying cancer histotypes, and in predicting patient outcomes independently. Known influencing factors significantly impact on numerical values, thus SUV values should be regarded with caution in clinical practice.https://doi.org/10.1186/s40644-024-00807-3Standardised uptake valuePositron emission tomography[18F]FDGLung lesionsPrognosisBiomarker |
| spellingShingle | Cristiano Pini Margarita Kirienko Fabrizia Gelardi Paola Bossi Daoud Rahal Luca Toschi Gaia Ninatti Marcello Rodari Giuseppe Marulli Lidija Antunovic Arturo Chiti Emanuele Voulaz Martina Sollini Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions Cancer Imaging Standardised uptake value Positron emission tomography [18F]FDG Lung lesions Prognosis Biomarker |
| title | Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions |
| title_full | Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions |
| title_fullStr | Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions |
| title_full_unstemmed | Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions |
| title_short | Challenging the significance of SUV-based parameters in a large-scale retrospective study on lung lesions |
| title_sort | challenging the significance of suv based parameters in a large scale retrospective study on lung lesions |
| topic | Standardised uptake value Positron emission tomography [18F]FDG Lung lesions Prognosis Biomarker |
| url | https://doi.org/10.1186/s40644-024-00807-3 |
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