TY - JOUR
T1 - Prognostic value of pre-treatment metabolic tumor volume on [S‑methyl‑11C]‑L‑methionine PET/CT in patients with local non-small cell lung carcinoma treated with single-fraction carbon-ion radiotherapy
AU - Tamura, Kentaro
AU - Nishii, Ryuichi
AU - Tsuji, Atsushi B.
AU - Tsukada, Jitsuro
AU - Maeda, Takamasa
AU - Nakajima, Mio
AU - Yamada, Shigeru
AU - Ishikawa, Hitoshi
AU - Yamazaki, Kana
AU - Higashi, Tatsuya
AU - Jinzaki, Masahiro
N1 - Publisher Copyright:
© The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine 2025.
PY - 2025/10
Y1 - 2025/10
N2 - Purpose: This study aimed to evaluate the prognostic predictive ability of MET PET/CT-derived imaging biomarkers in patients with localized non-small cell lung cancer (NSCLC) undergoing single-fraction carbon-ion radiotherapy (CIRT) and to clarify the additional prognostic information these biomarkers can provide beyond the standard UICC staging protocol. Methods: With institutional review board approval, 67 localized NSCLC patients eligible for CIRT between 2007 and 2012 were included. Single-fraction doses of 40–50 Gy were irradiated. MET PET imaging using the Toshiba Aquiduo or Siemens Biograph 16 commenced 20 min post 740 MBq MET injection before CIRT. Experienced radiologists analyzed the images, defining metabolic tumor volume (MTV) as areas with SUV > 1.5. Statistical analysis was performed using SPSS 29, including Cox proportional hazard models for disease-free and overall survival. Results: Seven cases with Tis of T stage were excluded because of low MET radiotracer uptake. A total of 60 patients were analyzed: 36 males and 24 females with a mean age of 73 years; 35 cases of T1, 24 cases of T2, and one T3 case. The average follow-up period was 74.3 months. The univariate Cox proportional hazard analyses showed that SUVmax, MTV, and total lesion retention (TLR) correlated with disease-free survival (DFS), while no significant difference was noted in treatment dose. For overall survival (OS), solid tumor diameter, SUVmax, MTV, TLR, and sex showed significant correlations in the univariate analysis. The multivariate analysis identified MTV as the only significant prognostic factor for both DFS and OS. Kaplan–Meier survival curves further supported these findings, with log-rank tests indicating a significant difference in survival duration related to MTV in both DFS and OS. Conclusion: MTV in pre-treatment MET PET/CT would be a valuable predictor of DFS and OS of localized NSCLC treated with single-fraction CIRT.
AB - Purpose: This study aimed to evaluate the prognostic predictive ability of MET PET/CT-derived imaging biomarkers in patients with localized non-small cell lung cancer (NSCLC) undergoing single-fraction carbon-ion radiotherapy (CIRT) and to clarify the additional prognostic information these biomarkers can provide beyond the standard UICC staging protocol. Methods: With institutional review board approval, 67 localized NSCLC patients eligible for CIRT between 2007 and 2012 were included. Single-fraction doses of 40–50 Gy were irradiated. MET PET imaging using the Toshiba Aquiduo or Siemens Biograph 16 commenced 20 min post 740 MBq MET injection before CIRT. Experienced radiologists analyzed the images, defining metabolic tumor volume (MTV) as areas with SUV > 1.5. Statistical analysis was performed using SPSS 29, including Cox proportional hazard models for disease-free and overall survival. Results: Seven cases with Tis of T stage were excluded because of low MET radiotracer uptake. A total of 60 patients were analyzed: 36 males and 24 females with a mean age of 73 years; 35 cases of T1, 24 cases of T2, and one T3 case. The average follow-up period was 74.3 months. The univariate Cox proportional hazard analyses showed that SUVmax, MTV, and total lesion retention (TLR) correlated with disease-free survival (DFS), while no significant difference was noted in treatment dose. For overall survival (OS), solid tumor diameter, SUVmax, MTV, TLR, and sex showed significant correlations in the univariate analysis. The multivariate analysis identified MTV as the only significant prognostic factor for both DFS and OS. Kaplan–Meier survival curves further supported these findings, with log-rank tests indicating a significant difference in survival duration related to MTV in both DFS and OS. Conclusion: MTV in pre-treatment MET PET/CT would be a valuable predictor of DFS and OS of localized NSCLC treated with single-fraction CIRT.
KW - Amino acid PET/CT
KW - Metabolic tumor volume
KW - Methionine PET/CT
KW - Non-small cell lung cancer
UR - https://www.scopus.com/pages/publications/105009435416
UR - https://www.scopus.com/pages/publications/105009435416#tab=citedBy
U2 - 10.1007/s12149-025-02067-y
DO - 10.1007/s12149-025-02067-y
M3 - Article
C2 - 40588678
AN - SCOPUS:105009435416
SN - 0914-7187
VL - 39
SP - 1074
EP - 1082
JO - Annals of Nuclear Medicine
JF - Annals of Nuclear Medicine
IS - 10
ER -
