Skeletal Muscle Metrics on Clinical 18F- FDG PET/CT Predict Health Outcomes in Patients with Sarcoma

Brent Foster, Robert D. Boutin, Leon Lenchik, David Gedeon, Yu Liu, Vinay Nittur, Ramsey D. Badawi, Chin-Shang Li, Robert J. Canter, Abhijit J. Chaudhari

Department of Biomedical Engineering, University of California Davis, Davis, CA, USA. Department of Radiology, University of California Davis School of Medicine, Sacramento, CA, USA. Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA. Department of Statistics, University of California Davis, Davis, CA, USA. Department of Public Health Sciences-Division of Biostatistics, University of California Davis, Davis, CA, USA. Department of Surgery, University of California Davis Medical Center, Sacramento, CA, USA.

The aim of this study was to determine the association of measures of skeletal muscle determined from 18F-FDG PET/CT with health outcomes in patients with soft-tissue sarcoma. 14 patients (8 women and 6 men; mean age 66.5 years) with sarcoma had PET/CT examinations. On CTs of the abdomen and pelvis, skeletal muscle was segmented, and cross-sectional muscle area, muscle volume, and muscle attenuation were determined. Within the segmented muscle, intramuscular fat area, volume, and density were derived. On PET images, the standardized uptake value (SUV) of muscle was determined. Regression analyses were conducted to determine the association between the imaging measures and health outcomes including overall survival (OS), local recurrence-free survival (LRFS), distant cancer recurrence (DCR), and major surgical complications (MSC). The association between imaging metrics and pre-therapy levels of serum C-reactive protein (CRP), creatinine, hemoglobin, and albumin was determined. Decreased volumetric muscle CT attenuation was associated with increased DCR. Increased PET SUV of muscle was associated with decreased OS and LRFS. Lower muscle SUV was associated with lower serum hemoglobin and albumin. Muscle measurements obtained on routine 18F-FDG PET/CT are associated with outcomes and serum hemoglobin and albumin in patients with sarcoma.

Journal of Nature and Science (JNSCI), 4(5):e502, 2018

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