Effects of the changes between pre- and post-treatment 18F-FDG PET-CT volumetric parameters on overall survival in pleural mesothelioma

Introduction. This study aimed to examine the efficacy of positron emission tomography in fusion with computed tomography (PET-CT) parameters in predicting survival outcomes for patients with malignant pleural mesothelioma.Material and methods. This study retrospectively evaluated the data of 250 patients who were followed up after a diagnosis of malignant pleural mesothelioma. The relationship of pre-treatment [maximum standardized uptake value (SUVmax1), metabolic tumor volume (MTV1), total lesion glycolysis (TLG1), tumor/background (TBR1), pleural thickness1), post-treatment (SUVmax2, MTV2, TLG2, TBR2, pleural thickness2], and APET-CT parameters with survival was retrospectively evaluated in 36 patients whose pre-and post-treatment CT scan examinations were complete.Results. The median age of the patients was 57.5 years, ranging from 35 to 76. Median follow-up time was 16 months, with a range of 7 to 42 months. Median survival was calculated as 18.8 months for all patients. Based on the determined cut-off values, overall survival was determined as 29.9 months in patients with TLG2 <= 158 compared to 16 months in patients with TLG2 > 158 (p = 0.009) and as 30.9 months in patients with ATLG <= -62.58 compared to 16 months in patients with ATLG > -62.58 (p = 0.001). In addition, median overall survival (OS) was determined as 29.9 months in patients with MTV2 <= 63.9 compared to 16 months in patients with MTV2 > 63.9 (p = 0.007) and as 29.9 months in patients with AMTV <=-54.03 compared to 16 months in patients with AMTV > -54.03 (p = 0.002). When evaluated with respect to TBR2; median OS was 29.9 months in patients with TBR2 <= 1.84 compared to 16 months in patients with TBR2 > 1.84 (p = 0.039).Conclusions. Our research findings indicate a correlation between OS and volumetric PET-CT measures, specifically TLG and MTV.