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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: 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). Methods: 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)]. Results: 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). Conclusions: 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.

Original languageEnglish
Pages (from-to)3155-3161
Number of pages7
JournalEuropean Radiology
Issue number9
StatePublished - 1 Sep 2016


  • 18F-FDG PET/CT
  • Metabolic parameters
  • Overall survival
  • Progression-free survival
  • Small cell lung cancer


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