J Cancer 2019; 10(7):1707-1716. doi:10.7150/jca.28605

Research Paper

Prognostic Value of MTV, SUVmax and the T/N Ratio of PET/CT in Patients with Glioma: A Systematic Review and Meta-Analysis

Qing Zhang1*, Xian Gao2*, Guohua Wei3*, Cheng Qiu4, Hongyi Qu1✉, Xin Zhou2✉

1. Department of Neurosurgery, Xinghua People's Hospital, Xinghua 225700, Jiangsu, P.R. China.
2. Department of Oncology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
3. Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
4. Department of Neurosurgery, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, P.R. China.
*These authors contributed equally to this work.

Abstract

Background: In the past decade, positron emission tomography/computed tomography (PET/CT) has become an important imaging tool for clinical assessment of tumor patients. Our meta-analysis aimed to compare the predictive value of PET/CT parameters regard to overall survival (OS) and progression-free survival (PFS) outcomes in glioma.

Methods: Relevant articles were systematically searched in PMC, PubMed, EMBASE and WEB of science. Studies involving the prognostic roles of PET/CT parameters with OS and PFS in glioma patients were evaluated. The impact of metabolic tumor volume (MTV), maximal standard uptake value (SUVmax), and the ratio of uptake in tumor to normal (T/N ratio) on survival was measured by calculating combined hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: A total of 32 articles with 1715 patients were included. The combined HRs of higher MTV, higher SUVmax and higher T/N ratio for OS were 1.14 (95% CI: 0.98-1.32, P heterogeneity<0.001), 1.69 (95% CI: 1.18-2.41, P heterogeneity<0.001) and 1.68 (95% CI: 1.40-2.01, P heterogeneity< 0.001), respectively. Regarding PFS, the combined HRs were 1.04 (95% CI: 0.97-1.11, P heterogeneity=0.002) with higher MTV, 1.45 (95% CI: 1.11-1.90, P heterogeneity<0.001) with higher SUVmax and 2.07 (95% CI: 1.45-2.95, P heterogeneity<0.001) with higher T/N ratio. Results remained similar in the sub-group analyses.

Conclusion: PET/CT parameters T/N ratio may be a significant prognostic factor in patients with glioma. Evidence of SUVmax and MTV needed more large-scale studies performed to validate. PET/CT scan could be a promising technique to provide prognostic information for these patients.

Keywords: PET/CT, MTV, SUVmax, T/N ratio, glioma, survival

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How to cite this article:
Zhang Q, Gao X, Wei G, Qiu C, Qu H, Zhou X. Prognostic Value of MTV, SUVmax and the T/N Ratio of PET/CT in Patients with Glioma: A Systematic Review and Meta-Analysis. J Cancer 2019; 10(7):1707-1716. doi:10.7150/jca.28605. Available from http://www.jcancer.org/v10p1707.htm