Predictive value of 18F-fluorodeoxyglucose positron emission tomography - computed tomography compared to postoperative pathological findings for patients with non-small-cell lung cancer

Abstract

Abstract. This study was conducted to investigate the predictive value of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG PET-CT) in patients with non-small-cell lung cancer (NSCLC), compared to that of postoperative pathological findings, for T and N staging and the associations of the metabolic parameters of the primary tumor with histological type and differentiation. The preoperative contrast-enhanced CT and 18 F-FDG PET-CT and postoperative pathological findings of 112 NSCLC patients treated with lobectomy or pneumonectomy combined with systematic mediastinal lymphadenectomy were retrospectively reviewed. Compared to the postoperative pathological findings, the effect of contrast-enhanced CT and 18 F-FDG PET-CT on T and N staging were evaluated. The metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) of the primary tumor were measured. The associations between these metabolic parameters and histological type and differentiation were also evaluated. The differences in the accuracy in overall staging and T staging between PET-CT and contrast-enhanced CT were significant (91.1 vs. 69.6%, P=0.000; and 92.9 vs. 76.8%, P=0.000, respectively). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of regional lymph node metastasis detection were 91.7, 93.0, 86.5, 95.8 and 92.6%, respectively, with PET-CT; and 71.3, 77.2, 60.6, 84.5 and 75.2%, respectively, with contrast-enhanced CT. The SUVmax , t=4.48, P=0.000) were significantly higher for squamous cell carcinoma (SCC) compared to those for adenocarcinoma (AC). There was a positive correlation between the MTV and SUVmax of the primary tumor (Pearson's r=0.838, P=0.000). Significant differences were observed among differentiation subgroups in the SUVmax and MTV of the primary tumor for both SCC and AC. In conclusion, compared to the postoperative pathological findings, the predictive value of 18 F-FDG PET-CT for T and N staging in NSCLC was higher compared to that of contrast-enhanced CT. The FDG uptake of the primary tumor was associated with histological type and differentiation and the difference was statistically significant. Therefore, the SUVmax and MTV of the primary tumor may be valuable indices to partly predict the histological type and grade of differentiation of NSCLC.

N-Staging in Large Cell Neuroendocrine Carcinoma of the Lung: Diagnostic Value of FDG PET/CT Compared to the Histopathology Reference Standard

“…In this respect, Lee et al demonstrated only moderate FDG uptake especially in lymph node metastases of adenocarcinomas which was signi cantly less than that of lymph node metastases from squamous cell carcinomas [22]. However, Xue et al reported more favorable results for N-staging in 112 NSCLC patients undergoing FDG PET/CT and subsequent surgery [23]. They found a sensitivity of 92% and a speci city of 93%, which are comparable to our LCNEC data.…”

The prognostic value of volume-based parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status

“…Generally, a lesion with higher FDG uptake has higher proliferation and reduced doubling time of tumor cells [24]. This can be seen in lung cancer patients, as primary lung cancer lesions showing higher SUV max generally have higher mass (MTV) [25,26]. However, the high metabolic activity in one primary site (SUV max ) and metastatic site (WB SUV max ) may not always be associated with a large metastatic burden.…”

FDG Uptake on Positron Emission Tomography Correlates with Survival and Time to Recurrence in Patients with Stage I Non–Small-Cell Lung Cancer

“…We determined that AC had a significantly lower metabolic activity than SCC and "other" histologies, consistent with prior reports. 19 This may reflect the inclusion of the more indolent forms of the AC subtype in our patient population, which are typically low in FDG uptake.…”