Abstract
Purpose
Our study intended to explore the association between combining 18F–FDG PET/CT metabolic parameters and other clinical features and anaplastic lymphoma kinase (ALK) or c-ros oncogene 1 (ROS1) fusion in non-small-cell lung cancer (NSCLC).
Methods
Eight hundred and six patients with wild-type epidermal growth factor receptor (EGFR) mutation were screened for ALK or ROS1 fusion and subjected to 18F–FDG PET/CT prior to treatment at our hospital. The associations between ALK or ROS1 fusion and clinical characteristics and the PET/CT parameters were analyzed. Multivariate logistic regression analysis was performed to explore independent deterministic factors associated with ALK and ROS1 fusion.
Results
Eighty-two patients (11.7%) with ALK fusion were found. Multivariate analysis demonstrated that high pSUVmax ≥ 10.6, low primary tumor lesion glycolysis (pTLG) < 101.8, young age, nonsmoker status, and high carcinoembryonic antigen (CEA) level correlated with ALK fusion in NSCLC. The receiver operating characteristic (ROC) curve yielded the area under curve (AUC) values of 0.603 and 0.873 for high pSUVmax alone and the combination of the five factors, respectively. Twenty-six patients (5.6%) with ROS1 fusion were found. Multivariate analysis revealed that high pSUVmax ≥ 8.8, young age, and nonsmoker status correlated with ROS1 fusion in NSCLC. The ROC curve yielded AUC values of 0.662 and 0.813 for high pSUVmax alone and the combination of the three factors, respectively.
Conclusion
The study indicated that combining 18F–FDG PET/CT metabolic parameters and other clinical parameters were correlated with ALK and ROS1 mutation in NSCLC patients and may help to refine the process of optimal patient selection to gene test for targeted therapy.
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References
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Funding
This study was supported by the Scientific Research project of Shanghai Municipal Commission of Health and Family Planning (grant number 20174Y0077), the Natural Science Foundation of Shanghai (grant number 18ZR1435200) and the National Natural Science Foundation of China (grant number 81602415).
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All procedures performed in studies involving human participants were approved by the Institutional Review Board of Shanghai Jiao Tong University-affiliated Shanghai Chest Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any animal experiments.
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Maomei Ruan and Liu Liu were the co-first authors.
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Ruan, M., Liu, L., Wang, L. et al. Correlation between combining 18F–FDG PET/CT metabolic parameters and other clinical features and ALK or ROS1 fusion in patients with non-small-cell lung cancer. Eur J Nucl Med Mol Imaging 47, 1183–1197 (2020). https://doi.org/10.1007/s00259-019-04652-6
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DOI: https://doi.org/10.1007/s00259-019-04652-6