THE ROLE OF 18F-FDG PET/CT MULTIPARAMETRIC IMAGING IN EVALUATING PROGNOSTIC OUTCOMES FOR ATHLETES WITH NON-SMALL CELL LUNG CANCER

Abstract

Objective: To explore the prognostic relevance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) multiparametric imaging in athletes with non-small cell lung cancer (NSCLC). Methods: A prospective cohort of 110 athletes diagnosed with NSCLC was monitored from March 2019 to October 2021. The cohort was divided based on TNM stages into 25 stage I, 49 stage II, and 36 stage III athletes. Follow-up at six months categorized 32 athletes as having tumor progression and 78 as stable. Variables such as age, tumor size, TNM stage, SUVmax, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were compared between groups. LASSO regression identified non-collinear indices, which, along with multivariate Cox regression, determined independent risk factors. Results: Variables like age, tumor diameter, TNM stage, SUVmax, MTV, and TLG were higher in the tumor progression group (P < 0.05). Multivariate analysis identified stage III (HR = 5.264), SUVmax (HR = 3.621), MTV (HR = 3.009), and TLG (HR = 2.659) as independent predictors of tumor progression. A quantitative model was established with an AUC of 0.859 for predicting tumor progression, demonstrating good consistency and clinical utility on calibration and decision curves. Conclusion: 18F-FDG PET/CT parameters, particularly SUVmax, MTV, and TLG, significantly correlate with NSCLC progression in athletes. A robust quantitative model integrating these parameters with TNM staging provides a valuable tool for predicting tumor behavior and guiding targeted interventions in this population.