FDG-PET and CT features of non-small cell lung cancer based on tumor type

Abstract

Abstract. We determined if specific tumor types of nonsmall cell lung cancer can be identified by variance in FDG-PET standard uptake value (SUV) in combination with characteristics on CT. Staging FDG-PET and CT scans of 81 patients (34 men and 47 women, average age 67±11 years) with 82 lung cancers were analyzed. Mean tumor SUV was calculated at the location of maximum FDG uptake. Tumor size, margins, and location were analyzed on CT. Statistical analysis compared SUV between tumor subtypes, assessed relationship between tumor subtype and features on CT and determined if combination of CT and SUV patterns predicted tumor type. In total 35 adenocarcinomas (AC); 15 bronchioloalveolar cell carcinomas (BAC), 23 squamous cell carcinomas and 9 large cell carcinomas were evaluated. Significant differences were found between SUV of all AC and squamous cell (p<0.0001); between all AC and large cell (p=0.03); between non-BAC AC and squamous cell types (p=0.0005); BAC and non-BAC AC (p=0.04), BAC and squamous cell (p<0.0001); BAC and large cell (p=0.004). Ground glass was the most significant CT feature in distinguishing tumor types, which was seen in BAC (p<0.0003). In conclusion, SUVs for non-small cell lung cancer were most significantly different between BAC and all other NCLC cell subtypes. The presence of ground glass in a nodule on CT is a significant feature for BAC and should raise the suspicion for this tumor type despite low FDG uptake.

Clinical usefulness of the fluorodeoxyglucose (FDG)-PET maximal standardized uptake value (SUV) in combination with CT features for the differentiation of adenocarcinoma with a bronchioloalveolar carcinoma from other subtypes of non-small cell lung cancers

“…In terms of the CT features, only a mixed pattern of partly solid and ground glass opacity was an important CT feature that distinguished an adenocarcinoma with BAC from the other histological NSCLC cell types in the current study and this result was in accord with other reports [7,[21][22][23][24]. Other CT findings such as margin, spiculation, associated pleural effusion and tumor location could not distinguish an adenocarcinoma with BAC from the other NSCLC subtypes.…”

“…The results of a low maximal SUV as depicted on FDG-PET and the presence of a mixed pattern lesion on CT image were similar to findings of prior studies that have examined pure BACs [7], and the results could be extended for an adenocarcinoma with BAC as for a pure BAC. Therefore, the combination of the CT findings and the maximal SUV for NSCLCs might allow one to predict accurately the presence of an adenocarcinoma with BAC among NSCLCs.…”

“…However, subtypes of adenocarcinomas such as an adenocarcinoma with a bronchioloalveolar carcinoma (adenocarcinoma with BAC) and pure BACs (approximately 20% of early-stage NSCLC cases) have a much better prognosis than other subtypes of adenocarcinomas with a similar stage [5,6]. Aquino et al have reported that the standardized uptake values (SUVs) of pure BACs were significantly lower than all other NSCLC cell subtypes and the presence of ground glass opacity for a nodule as seen on CT images is an important feature for BACs [7]. However, a pure BAC that has no invasive components represents about 3% to 4% of all lung cancers, whereas an adenocarcinoma with BAC is far more common [8].…”

“…Therefore, we intend to evaluate the features applicable for an adenocarcinoma with BAC. To the best of our knowledge, there have been only a few reports about the clinical usefulness of the fluorodeoxyglucose (FDG)-PET maximal SUV for the differentiation of an adenocarcinoma with BAC from the other subtypes of non-small cell lung cancer [7,9]. Moreover, there are scant reports regarding the clinical usefulness of the maximal SUV in combination with CT findings for the differentiation of tumors.…”

Localized mucinous bronchioloalveolar carcinoma of the lung: thin-section computed tomography and fluorodeoxyglucose positron emission tomography findings

“…These results were consistent with those of previous reports. 2,6,7,[9][10][11][13][14][15][16][17] Lee et al reported that in mucinous BACs that none of six nodules had a spiculated margin, and all nodules had solid portions. 2 Regarding internal characteristics, air-containing spaces were unexceptionally present: bubble-like lucencies in four cases, cavitation in one case, and air-bronchogram in one case.…”