18F FDG-PET/CT analysis of spread through air spaces (STAS) in clinical stage I lung adenocarcinoma

Nishimori, Miki; Iwasa, Hitomi; Miyatake, Kana; Nitta, Noriko; Nakaji, Keisuke; Matsumoto, Tomohiro; Yamanishi, Tomoaki; Yoshimatsu, Rika; Iguchi, Mituko; Tamura, Masaya; Yamagami, Takuji

doi:10.1007/s12149-022-01773-1

Cited by 9 publications

(10 citation statements)

References 28 publications

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“…In this study, SUV max emerged as an independent risk predictor for predicting STAS. Higher SUV max values indicate stronger metabolic activity and tumor aggressiveness, correlating with an increased positive rate of STAS, consistent with findings from prior studies (Wang et al 2020 ; Nishimori et al 2022 ). Subgroup analysis revealed that SUV max was an independent risk predictor for predicting STAS in solid nodular NSCLC.…”

Section: Discussionsupporting

confidence: 90%

“…Wang et al ( 2020 ) demonstrated the value of SUV max and total lesion glycolysis (TLG) as indicators for predicting STAS, achieving a diagnostic accuracy of 71.1% and an area under the curve (AUC) value of 0.759. Nishimori et al ( 2022 ) identified an SUV max cut-off value of 2.48, yielding a sensitivity, specificity, and AUC value of 89.5%, 52.8%, and 0.74, respectively. Few studies have explored predicting STAS based on 18 F-FDG PET/CT metabolic parameters combined with CT features.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using 18F-fluorodeoxyglucose positron emission tomography/computed tomography

Wang,

Lyu,

Cheng

et al. 2024

J Cancer Res Clin Oncol

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Purpose This study aims to assess the predictive value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) radiological features and the maximum standardized uptake value (SUVmax) in determining the presence of spread through air spaces (STAS) in clinical-stage IA non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted on 180 cases of NSCLC with postoperative pathological assessment of STAS status, spanning from September 2019 to September 2023. Of these, 116 cases from hospital one comprised the training set, while 64 cases from hospital two formed the testing set. The clinical information, tumor SUVmax, and 13 related CT features were analyzed. Subgroup analysis was carried out based on tumor density type. In the training set, univariable and multivariable logistic regression analyses were employed to identify the most significant variables. A multivariable logistic regression model was constructed and the corresponding nomogram was developed to predict STAS in NSCLC, and its diagnostic efficacy was evaluated in the testing set. Results SUVmax, consolidation-to-tumor ratio (CTR), and lobulation sign emerged as the best combination of variables for predicting STAS in NSCLC. Among these, SUVmax and CTR were identified as independent predictors for STAS prediction. The constructed prediction model demonstrated area under the curve (AUC) values of 0.796 and 0.821 in the training and testing sets, respectively. Subgroup analysis revealed a 2.69 times higher STAS-positive rate in solid nodules compared to part-solid nodules. SUVmax was an independent predictor for predicting STAS in solid nodular NSCLC, while CTR and an emphysema background were independent predictors for STAS in part-solid nodular NSCLC. Conclusion Our nomogram based on preoperative 18F-FDG PET/CT radiological features and SUVmax effectively predicts STAS status in clinical-stage IA NSCLC. Furthermore, our study highlights that metabolic parameters and CT variables associated with STAS differ between solid and part-solid nodular NSCLC.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using 18F-fluorodeoxyglucose positron emission tomography/computed tomography

Wang,

Lyu,

Cheng

et al. 2024

J Cancer Res Clin Oncol

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“…Similar to the literature, no signi cant difference was found between patients with and without STAS in terms of age, gender, tumor size, and tumor location [8]. It has even been reported that SUVmax is a valuable indicator for the prediction of STAS in clinical Stage I lung adenocarcinoma [9]. In contrast to these results, we concluded in our study that SUVmax values were not a su cient parameter to predict STAS positivity.…”

Section: Discussionsupporting

confidence: 71%

The Effect of STAS Positivity in Lung Cancer

INAN,

İNAN,

CELIK

et al. 2023

Preprint

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Aim of study: The spread through air spaces (STAS) phenomenon, which describes the presence of tumor cells in the air spaces of lung cancer, has been associated with an increased risk of local recurrence. We performed retrospective analyses to examine the presence of STAS and to evaluate its clinical results and its relationship with clinicopathological parameters. Materials and Methods: A total of 149 surgically resected lung cancer cases were analyzed retrospectively. Detailed analyses were performed on demographic- radiological-clinical-histological features. Results: The mean age of the patients was 63 (IQR = 11; range, 22–81), among whom 31 were female and 118 were male. The incidence of STAS was not different between the histological groups (p = 0.427). There was no difference between SUVmax value in STAS-positive and negative patients (p = 0.970). The recurrence rate, survival, and median tumor size were not different from each other in the STAS-positive and STAS-negative groups (p = 1,000, p = 0.086, p = 0.292, respectively). Conclusion: STAS is an independent risk factor for poor prognosis. Therefore, it may be possible to provide more personalized information by using clinicopathological markers that will facilitate preoperative prediction of STAS presence.

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“…Currently, there are several clinical studies about C/T ratio with STAS and confirmed that the C/T ratio was associated with STAS positive tumors [ 18 , 19 ]. In a previous study, STAS was significantly related to 18F FDG-PET findings, especially SUVmax value [ 20 ] and MTV/CTV ratio [ 21 ]. Kim et al reported that STAS was more common in solid tumors than in part-solid or ground-glass lesions [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Mean computed tomography value to predict spread through air spaces in clinical N0 lung adenocarcinoma

Yamamoto,

Tamura,

Miyazaki

et al. 2024

J Cardiothorac Surg

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Background The aim of this study was to assess the ability of radiologic factors such as mean computed tomography (mCT) value, consolidation/tumor ratio (C/T ratio), solid tumor size, and the maximum standardized uptake (SUVmax) value by F-18 fluorodeoxyglucose positron emission tomography to predict the presence of spread through air spaces (STAS) of lung adenocarcinoma. Methods A retrospective study was conducted on 118 patients those diagnosed with clinically without lymph node metastasis and having a pathological diagnosis of adenocarcinoma after undergoing surgery. Receiver operating characteristics (ROC) analysis was used to assess the ability to use mCT value, C/T ratio, tumor size, and SUVmax value to predict STAS. Univariate and multiple logistic regression analyses were performed to determine the independent variables for the prediction of STAS. Results Forty-one lesions (34.7%) were positive for STAS and 77 lesions were negative for STAS. The STAS positive group was strongly associated with a high mCT value, high C/T ratio, large solid tumor size, large tumor size and high SUVmax value. The mCT values were − 324.9 ± 19.3 HU for STAS negative group and − 173.0 ± 26.3 HU for STAS positive group (p < 0.0001). The ROC area under the curve of the mCT value was the highest (0.738), followed by SUVmax value (0.720), C/T ratio (0.665), solid tumor size (0.649). Multiple logistic regression analyses using the preoperatively determined variables revealed that mCT value (p = 0.015) was independent predictive factors of predicting STAS. The maximum sensitivity and specificity were obtained at a cutoff value of − 251.8 HU. Conclusions The evaluation of mCT value has a possibility to predict STAS and may potentially contribute to the selection of suitable treatment strategies.

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18F FDG-PET/CT analysis of spread through air spaces (STAS) in clinical stage I lung adenocarcinoma

Cited by 9 publications

References 28 publications

Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using 18F-fluorodeoxyglucose positron emission tomography/computed tomography

Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using 18F-fluorodeoxyglucose positron emission tomography/computed tomography

The Effect of STAS Positivity in Lung Cancer

Mean computed tomography value to predict spread through air spaces in clinical N0 lung adenocarcinoma

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