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18-12-2015 | Small-cell lung cancer | Article

The Role of 18F-FDG PET/CT on Staging and Prognosis in Patients with Small Cell Lung Cancer

European Radiology

Authors: A. Zer, L. Domachevsky, Y. Rapson, M. Nidam, D. Flex, A. M. Allen, S. M. Stemmer, D. Groshar, H. Bernstine

Publisher: Springer Berlin Heidelberg



We evaluated 18F-FDG PET/CT in small cell lung cancer (SCLC) staging and assessed metabolic (SUVmax, MTV and TLG) and morphologic (CTvol) variables as predictors for overall survival (OS) and progression-free survival (PFS).


Patients with newly diagnosed, histopathology-confirmed SCLC, who underwent 18F-FDG PET/CT were evaluated. A Cox proportional hazard model was used to determine the association between the primary tumour SUVmax, MTV, TLG and CTvol with OS and PFS. Similar evaluations were performed when hilar/mediastinal lymphadenopathy was included [total SUVmax (TSUVmax), total MTV (TMTV) and total TLG (TTLG)].


55 patients were included. 18F-FDG PET/CT changed staging in 6/55 (10.9%) patients who were upstaged to extensive disease. TTLG (>443.8) was a significant variable for OS with HR=2.1 (CI 1.14–3.871, p=0.017). Patients with TTLG>443.8 had a median OS of 13.4 months compared to 25.7 months in patients with TTLG<443.8 (p=0.018). TMTV (>72.4) was significant for PFS with HR=2.3 (CI 1.11-4.8, p=0.025). A median PFS of 12.1 and 26.2 months was found with TMTV greater and less than 72.4, respectively (p=0.005).


18F-FDG PET/CT improved staging of patients with SCLC, and TTLG and TMTV can be used as prognostic variables for OS and PFS, respectively.

Key Points

Identifying variables that predict the prognosis of patients with SCLC is important.
18F-FDG PET/CT influences staging of patients with SCLC.
Metabolic parameters could be used as predictors for PFS and OS.

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