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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

European Journal of Nuclear Medicine and Molecular Imaging volume 47, pages 1183–1197 (2020)Cite this article

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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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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  1. Yan Shen and Wenhui Xie contributed equally to this work.

Affiliations

  1. Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China

    Maomei Ruan, Liu Liu, Lihua Wang, Bei Lei, Xiaoyan Sun, Cheng Chang & Wenhui Xie

  2. Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, People’s Republic of China

    Yan Shen

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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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Keywords

  • Anaplastic lymphoma kinase
  • C-ros oncogene 1
  • Non-small cell lung cancer
  • Standard uptake value
  • Total lesion glycolysis