Preoperative 18F-FDG SUVmax >6.3 or Size >2.3 cm of primary lesions predict lymph nodes metastasis with higher negative predictive value in peripheral cT1 non-small-cell lung cancer

Abstract

Background Sublobar resection is suitable for peripheral cT1N0M0 non-small-cell lung cancer (NSCLC). The traditional PET-CT criterion (lymph node size ≥1.0 cm or SUV max ≥2.5) for predicting lymph nodes metastasis (LNM) has unsatisfactory performance.Objective We explore the clinical role of preoperative SUV max and the size of the primary lesions for predicting peripheral cT1 NSCLC LNM. MethodsWe retrospectively analyzed 174 peripheral cT1 NSCLC patients underwent preoperative 18 F-FDG PET-CT and divided into the LNM and non-LNM group by pathology. We compared the differences of primary lesions' baseline characteristics between the two groups. The risk factors of LNM were determined by univariate and multivariate analysis, and we assessed the diagnostic efficacy with the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value (NPV). ResultsOf the enrolled cases, the incidence of LNM was 24.7%. The preoperative SUV max >6.3 or size >2.3 cm of the primary lesions were independent risk factors of peripheral cT1 NSCLC LNM (ORs, 95% CIs were 6.18 (2.40-15.92) and 3.03 (1.35-6.81). The sensitivity, NPV of SUV max >6.3 or size >2.3 cm of the primary lesions were higher than the traditional PET-CT criterion for predicting LNM (100.0 vs. 86.0%, 100.0 vs. 89.7%). A Hosmer-Lemeshow test showed a goodness-of-fit (P = 0.479). ConclusionsThe excellent sensitivity and NPV of preoperative of the SUV max >6.3 or size >2.3 cm of the primary lesions based on 18 F-FDG PET-CT might identify the patients at low-risk LNM in peripheral cT1 NSCLC. Nucl Med Commun 42: 1328