Recent and Current Advances in FDG-PET Imaging within the Field of Clinical Oncology in NSCLC: A Review of the Literature

Abstract

Lung cancer is the leading cause of cancer-related deaths around the world, the most common type of which is non-small-cell lung cancer (NSCLC). Computed tomography (CT) is required for patients with NSCLC, but often involves diagnostic issues and large intra- and interobserver variability. The anatomic data obtained using CT can be supplemented by the metabolic data obtained using fluorodeoxyglucose F 18 (FDG) positron emission tomography (PET); therefore, the use of FDG-PET/CT for staging NSCLC is recommended, as it provides more accuracy than either modality alone. Furthermore, FDG-PET/magnetic resonance imaging (MRI) provides useful information on metabolic activity and tumor cellularity, and has become increasingly popular. A number of studies have described FDG-PET/MRI as having a high diagnostic performance in NSCLC staging. Therefore, multidimensional functional imaging using FDG-PET/MRI is promising for evaluating the activity of the intratumoral environment. Radiomics is the quantitative extraction of imaging features from medical scans. The chief advantages of FDG-PET/CT radiomics are the ability to capture information beyond the capabilities of the human eye, non-invasiveness, the (virtually) real-time response, and full-field analysis of the lesion. This review summarizes the recent advances in FDG-PET imaging within the field of clinical oncology in NSCLC, with a focus on surgery and prognostication, and investigates the site-specific strengths and limitations of FDG-PET/CT. Overall, the goal of treatment for NSCLC is to provide the best opportunity for long-term survival; therefore, FDG-PET/CT is expected to play an increasingly important role in deciding the appropriate treatment for such patients.

Value of Shape and Texture Features from 18F-FDG PET/CT to Discriminate between Benign and Malignant Solitary Pulmonary Nodules: An Experimental Evaluation

“…In recent years, quantitative extraction of imaging features from medical scans ("radiomics" [13][14][15]) has attracted widespread interest as a possible means to discriminate between benign vs. malignant SPN [16]. The rationale behind radiomics is to leverage on that fraction of image information which may have clinical relevance but go unnoticed to the human eye [17].…”

Quantitative FDG PET Assessment for Oncology Therapy

“…In radiomics, a large number of indicators are calculated [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. Previously, when only SUVmax was utilized, univariate analysis and receiver operator curve analysis were enough to determine whether the particular indicator was a useful predictor for histological or genetic characteristics and prognosis [ 59 ].…”

Influencing Factors and Prognostic Value of 18F-FDG PET/CT Metabolic and Volumetric Parameters in Non-Small Cell Lung Cancer

“…8 Usually, PET/CT is required for NSCLC patients. 9 [ 18 F]fluorodeoxyglucose ( 18 F-FDG) is the most commonly used molecular probe for PET, which is a glucose analogue that can indirectly reflect glucose metabolism and tumor cell proliferation. 10 In order to enable PET to more accurately evaluate tumors, the study of 18 F-FDG PET metabolism is particularly important.…”