Correlation between FDG-PET/CT findings and solid type non-small cell cancer prognostic factors: are there differences b
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ORIGINAL ARTICLE
Correlation between FDG-PET/CT findings and solid type non-small cell cancer prognostic factors: are there differences between adenocarcinoma and squamous cell carcinoma? Rintaro Ito1 • Shingo Iwano1 Shinji Naganawa1
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Mariko Kishimoto1 • Shinji Ito1 • Katsuhiko Kato2
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Received: 15 June 2015 / Accepted: 12 August 2015 / Published online: 5 September 2015 Ó The Japanese Society of Nuclear Medicine 2015
Abstract Objectives The maximum standardized uptake value (SUVmax) of FDG-PET/CT is commonly used as an indicator to evaluate the invasiveness and prognosis of non-small-cell lung cancers (NSCLC). We investigated the correlation between SUVmax and tumor invasiveness or postoperative recurrence of solid type NSCLC and compared squamous cell carcinoma (SCC)/adenosquamous carcinoma (ASC) to adenocarcinoma (AC). Methods A retrospective review of preoperative PET/CT, thin-section CT, and postoperative pathological records obtained over a 5-year period was conducted. Solid type NSCLC tumors on thin-section CT with confirmed diagnosis from surgical resection (diameter B3 cm) were included. Multivariate logistic regression was used to evaluate the correlation between tumor characteristics and pathological prognostic factors or postoperative recurrence. Results 150 patients (111 males, 39 females; mean age 67 years; 106 cases of AC, 36 cases of SCC, and 8 cases of ASC) were included. SUVmax was significantly correlated with pleural involvement (p = 0.047), lymphatic permeation (p = 0.003), lymph node metastasis (p = 0.027), and tumor invasiveness (p \ 0.001). Receiver operating characteristic analysis indicated an optimal SUVmax threshold of 5.0 for tumor invasiveness. Histopathological type was
& Shingo Iwano [email protected] 1
Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
2
Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya 461-8673, Japan
significantly correlated with pleural involvement (p = 0.042), but not with other types of invasiveness. Twenty-nine patients experienced postoperative recurrence. SUVmax was significantly correlated with tumor recurrence (p = 0.004), but size and histopathological type were not (p = 0.502 and p = 0.351, respectively). Conclusion SUVmax of the primary lesion in solid type NSCLC was significantly correlated with tumor invasiveness and postoperative recurrence. No differences in tumor invasiveness were observed between solid type AC and SCC/ASC. However, in solid type AC, SUVmax of the primary lesion was more significantly correlated with recurrence. Keywords Non-small-cell lung cancer Adenocarcinoma Squamous cell carcinoma Adenosquamous carcinoma Positron emission tomography
Introduction Primary lung cancer is the leading cause of cancer-related deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for 85 % of lung cancer deaths [1, 2]. NSCLC consists chiefly of ad
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