Skip to main content

Advertisement

SpringerLink
Log in

Correlation between FDG-PET/CT findings and solid type non-small cell cancer prognostic factors: are there differences between adenocarcinoma and squamous cell carcinoma?

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

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 ≤3 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 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e1S–29S.

    Article  CAS  PubMed  Google Scholar 

  2. Sawabata N, Asamura H, Goya T, Mori M, Nakanishi Y, Eguchi K, et al. Japanese Lung Cancer Registry Study: first prospective enrollment of a large number of surgical and nonsurgical cases in 2002. J Thorac Oncol. 2010;5:1369–75.

    Article  PubMed  Google Scholar 

  3. Watanabe Y, Tsuta K, Kusumoto M, Yoshida A, Suzuki K, Asamura H, et al. Clinicopathologic features and computed tomographic findings of 52 surgically resected adenosquamous carcinomas of the lung. Ann Thorac Surg. 2014;97:245–51.

    Article  PubMed  Google Scholar 

  4. Cooke DT, Nguyen DV, Yang Y, Chen SL, Yu C, Calhoun RF. Survival comparison of adenosquamous, squamous cell, and adenocarcinoma of the lung after lobectomy. Ann Thorac Surg. 2010;90:943–8.

    Article  PubMed  Google Scholar 

  5. Takamori S, Noguchi M, Morinaga S, Goya T, Tsugane S, Kakegawa T, et al. Clinicopathologic characteristics of adenosquamous carcinoma of the lung. Cancer. 1991;67:649–54.

    Article  CAS  PubMed  Google Scholar 

  6. Shiono S, Abiko M, Sato T. Limited resection for clinical Stage IA non-small-cell lung cancers based on a standardized-uptake value index. Eur J Cardiothorac Surg. 2013;43:e7–12.

    Article  PubMed  Google Scholar 

  7. Ohtsuka T, Nomori H, Watanabe K, Kaji M, Naruke T, Suemasu K, et al. Prognostic significance of [(18)F]fluorodeoxyglucose uptake on positron emission tomography in patients with pathologic stage I lung adenocarcinoma. Cancer. 2006;107:2468–73.

    Article  PubMed  Google Scholar 

  8. Okada M, Nakayama H, Okumura S, Daisaki H, Adachi S, Yoshimura M, et al. Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma. J Thorac Cardiovasc Surg. 2011;141:1384–91.

    Article  PubMed  Google Scholar 

  9. Suzuki K, Kusumoto M, Watanabe S, Tsuchiya R, Asamura H. Radiologic classification of small adenocarcinoma of the lung: radiologic-pathologic correlation and its prognostic impact. Ann Thorac Surg. 2006;81:413–9.

    Article  PubMed  Google Scholar 

  10. Iwano S, Kishimoto M, Ito S, Kato K, Ito R, Naganawa S. Prediction of pathologic prognostic factors in patients with lung adenocarcinomas: comparison of thin-section computed tomography and positron emission tomography/computed tomography. Cancer Imaging 2014;14.

  11. Tsutani Y, Miyata Y, Misumi K, Ikeda T, Mimura T, Hihara J, et al. Difference in prognostic significance of maximum standardized uptake value on [18F]-fluoro-2-deoxyglucose positron emission tomography between adenocarcinoma and squamous cell carcinoma of the lung. Jpn J Clin Oncol. 2011;41:890–6.

    Article  PubMed  Google Scholar 

  12. Lu P, Yu L, Li Y, Sun Y. A correlation study between maximum standardized uptake values and pathology and clinical staging in nonsmall cell lung cancer. Nucl Med Commun. 2010;31:646–51.

    PubMed  Google Scholar 

  13. Li M, Sun Y, Liu Y, Han A, Zhao S, Ma L, et al. Relationship between primary lesion FDG uptake and clinical stage at PET-CT for non-small cell lung cancer patients: An observation. Lung Cancer. 2010;68:394–7.

    Article  PubMed  Google Scholar 

  14. Aoki T, Tomoda Y, Watanabe H, Nakata H, Kasai T, Hashimoto H, et al. Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival. Radiology. 2001;220:803–9.

    Article  CAS  PubMed  Google Scholar 

  15. Ohde Y, Nagai K, Yoshida J, Nishimura M, Takahashi K, Suzuki K, et al. The proportion of consolidation to ground-glass opacity on high resolution CT is a good predictor for distinguishing the population of non-invasive peripheral adenocarcinoma. Lung Cancer. 2003;42:303–10.

    Article  PubMed  Google Scholar 

  16. Perkins NJ, Schisterman EF. The inconsistency of “optimal” cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670–5.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32–5.

    Article  CAS  PubMed  Google Scholar 

  18. Ozeki N, Iwano S, Taniguchi T, Kawaguchi K, Fukui T, Ishiguro F, et al. Therapeutic surgery without a definitive diagnosis can be an option in selected patients with suspected lung cancer. Interact Cardio Vasc Thorac Surg. 2014;19:830–7.

    Article  Google Scholar 

  19. Iwano S, Ito S, Tsuchiya K, Kato K, Naganawa S. What causes false-negative PET findings for solid-type lung cancer? Lung Cancer. 2013;79:132–6.

    Article  PubMed  Google Scholar 

  20. Higashi K, Ito K, Hiramatsu Y, Ishikawa T, Sakuma T, Matsunari I, et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in non-small cell lung cancer: analysis of a multicenter study. J Nucl Med. 2005;46:267–73.

    PubMed  Google Scholar 

  21. Ishibashi T, Kaji M, Kato T, Ishikawa K, Kadoya M, Tamaki N. 18F-FDG uptake in primary lung cancer as a predictor of intratumoral vessel invasion. Ann Nucl Med. 2011;25:547–53.

    Article  CAS  PubMed  Google Scholar 

  22. Pechet TT, Carr SR, Collins JE, Cohn HE, Farber JL. Arterial invasion predicts early mortality in stage I non-small cell lung cancer. Ann Thorac Surg. 2004;78:1748–53.

    Article  PubMed  Google Scholar 

  23. Usui S, Minami Y, Shiozawa T, Iyama S, Satomi K, Sakashita S, et al. Differences in the prognostic implications of vascular invasion between lung adenocarcinoma and squamous cell carcinoma. Lung Cancer. 2013;82:407–12.

    Article  PubMed  Google Scholar 

  24. Uehara H, Tsutani Y, Okumura S, Nakayama H, Adachi S, Yoshimura M, et al. Prognostic role of positron emission tomography and high-resolution computed tomography in clinical stage IA lung adenocarcinoma. Ann Thorac Surg. 2013;96:1958–65.

    Article  PubMed  Google Scholar 

  25. Jeong HJ, Min JJ, Park JM, Chung JK, Kim BT, Jeong JM, et al. Determination of the prognostic value of [(18)F]fluorodeoxyglucose uptake by using positron emission tomography in patients with non-small cell lung cancer. Nucl Med Commun. 2002;23:865–70.

    Article  CAS  PubMed  Google Scholar 

  26. Chen X, Zhao J, Guan YH, Lu S, Zuo CT, Hua FC, et al. Prognostic value of 2-[18F]fluoro-2-deoxy-d-glucose uptake as measured by PET scan in patients with non-small cell lung cancer. Mol Med Rep. 2008;1:889–93.

    CAS  PubMed  Google Scholar 

  27. Koike T, Koike T, Yamato Y, Yoshiya K, Toyabe S. Prognostic predictors in non-small cell lung cancer patients undergoing intentional segmentectomy. Ann Thorac Surg. 2012;93:1788–94.

    Article  PubMed  Google Scholar 

  28. Nomori H, Mori T, Ikeda K, Yoshimoto K, Iyama K, Suzuki M. Segmentectomy for selected cT1N0M0 non-small cell lung cancer: a prospective study at a single institute. J Thorac Cardiovasc Surg. 2012;144:87–93.

    Article  PubMed  Google Scholar 

  29. Sienel W, Stremmel C, Kirschbaum A, Hinterberger L, Stoelben E, Hasse J, et al. Frequency of local recurrence following segmentectomy of stage IA non-small cell lung cancer is influenced by segment localisation and width of resection margins—implications for patient selection for segmentectomy. Eur J Cardiothorac Surg 2007;31: 522–527 (discussion 527–528).

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Rintaro Ito, Shingo Iwano, Mariko Kishimoto, Shinji Ito & Shinji Naganawa

  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

    Katsuhiko Kato

Authors
  1. Rintaro Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shingo Iwano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariko Kishimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shinji Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katsuhiko Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinji Naganawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shingo Iwano.

Ethics declarations

Conflict of interest

None declared.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ito, R., Iwano, S., Kishimoto, M. et al. Correlation between FDG-PET/CT findings and solid type non-small cell cancer prognostic factors: are there differences between adenocarcinoma and squamous cell carcinoma?. Ann Nucl Med 29, 897–905 (2015). https://doi.org/10.1007/s12149-015-1025-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-015-1025-z

Keywords

Search

Navigation