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A. Viti
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P1.08 - Locally Advanced NSCLC (ID 694)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.08-005 - Preoperative Analysis of 18FDG-PET Features May Predict Loco-Regional Invasiveness in NSCLC (ID 8328)
09:30 - 09:30 | Author(s): A. Viti
- Abstract
Background:
Prognosis of surgically resectable NSCLC is strongly affected by local invasiveness as well as unexpected lymph node diffusion found at surgery (nodal upstaging). Recently, texture analysis of PET imaging has emerged as a powerful tool to better define the metabolic features and behavior of neoplasms. This study is meant to evaluate the relationship of texture analysis features of surgically resected NSCLC with local invasiveness, represented by lymphovascular invasion (LI), and regional subclinical diffusion, evaluated as nodal upstaging (NU) at the pathological staging.
Method:
The study is a retrospective evaluation of prospectively collected data. We performed a spatial texture analysis of the preoperative PET-CT scans of completely resected clinical stage Ia-IIb (T1-3, N0-1) NSCLC, focusing on 11 parameters: SUVmax, Metabolic Tumor Volume (MTV), Entropy (baseline), Homogeneity, High Intensity Run Emphasis, Low Intensity Run Emphasis, Coarseness, Busyness, Normalized Entropy, Normalized Homogeneity, Normalized Inverse Difference Moment (NIDM), SUV standard deviation (SUV SD), SUV Entropy. We then evaluated their relationship with LI, NU and Disease-Free Survival (DFS).
Result:
In the period between February 2012 and September 2016 we operated on 75 patients (53 male and 22 female); pathological stage revealed a nodal upstaging in 12 cases (6 pN1 and 6 pN2), while in 11 patients it showed a LI. Patients with NU had a restricted mean DFS of 19.8 months (CI 95% 12.7-26.8) and showed higher levels of SUVmax; SUV Entropy; Normalized Entropy; SUV SD and lower level of Normalized Homogeneity and NIDM. Patients with LI had a restricted mean DFS of 21.4 months (CI 95% 8.8-34,1) and displayed higher levels of SUVmax, SUV Entropy, Normalized Entropy, SUV SD and lower level of NIDM. ROC analysis confirmed a stronger predictive value of heterogeneity indexes when compared to SUVmax; in particular SUV SD had the best ROC area for LI and SUV entropy showed the best ROC for NU. Concurrently, both LI and NU emerged as significant prognostic factors for DFS both in univariate (p=0.0076 and p=0.0167 respectively) and multivariate analysis (p=0.005 and p=0.021 respectively).
Conclusion:
In our analysis, preoperative PET-CT texture analysis has a significant correlation with prognostic indicators and tumor local invasiveness; this analysis may provide a more precise stratification of patients affected by highly aggressive tumors from the very beginning of patient’s diagnostic path.
