FDG-PET/CT and diffusion-weighted imaging for resected lung cancer: correlation of maximum standardized uptake value and apparent diffusion coefficient value with prognostic factors

Abstract

Diffusion-weighted magnetic resonance imaging (DWI) is useful for detecting malignant tumors and the assessment of lymph nodes, as FDG-PET/CT is. But it is not clear how DWI influences the prognosis of lung cancer patients. The focus of this study is to evaluate the correlations between maximum standardized uptake value (SUVmax) of FDG-PET/CT and apparent diffusion coefficient (ADC) value of DWI with known prognostic factors in resected lung cancer. A total of 227 patients with resected lung cancers were enrolled in this study. FEG-PET/CT and DWI were performed in each patient before surgery. There were 168 patients with adenocarcinoma, 44 patients with squamous cell carcinoma, and 15 patients with other cell types. SUVmax was a factor that was correlated to T factor, N factor, or cell differentiation. ADC of lung cancer was a factor that was not correlated to T factor, or N factor. There was a significantly weak inverse relationship between SUVmax and ADC (Correlation coefficient r = − 0.227). In analysis of survival, there were significant differences between the categories of sex, age, pT factor, pN factor, cell differentiation, cell type, and SUVmax. Univariate analysis revealed that SUVmax, pN factor, age, cell differentiation, cell type, sex, and pT factor were significant factors. Multivariate analysis revealed that SUVmax and pN factor were independent significant prognostic factors. SUVmax was a significant prognostic factor that is correlated to T factor, N factor, or cell differentiation, but ADC was not. SUVmax may be more useful for predicting the prognosis of lung cancer than ADC values.

18FDG Positron Emission Tomography Mining for Metabolic Imaging Biomarkers of Radiation-induced Xerostomia in Patients with Oropharyngeal Cancer

“…One possible explanation of the decrease in median SUV is the reduction in acinar cells [16-19] with simultaneous increase of intercellular water or fat, which can be visualized in magnetic resonance imaging (MRI) by an increase in T2 [20, 21] or ADC [22], and a rising fat fraction in DIXON MRI. [20] The direct negative correlation between ADC and FDG uptake [23] has been confirmed in several studies using a simultaneous PET/MR in pre-treatment HNC [24], lung cancer [25], lymphoma [26], and liver metastases [27] or post-RT as in rectal cancer [28] and retroperitoneal fibrosis. [29]…”

18FDG positron emission tomography mining for metabolic imaging biomarkers of radiation-induced xerostomia in patients with oropharyngeal cancer

“…One possible explanation of the decrease in median SUV is the reduction in acinar cells [16][17][18][19] with simultaneous increase of intercellular water or fat, which can be visualized in magnetic resonance imaging (MRI) by an increase in T2 [20,21] or ADC [22], and a rising fat fraction in DIXON MRI [20]. The direct negative correlation between ADC and FDG uptake [23] has been confirmed in several studies using a simultaneous PET/MR in pre-treatment HNC [24], lung cancer [25], lymphoma [26], and liver metastases [27] or post-RT as in rectal cancer [28] and retroperitoneal fibrosis [29].…”

18F-fluorothymidine (FLT)-PET and diffusion-weighted MRI for early response evaluation in patients with small cell lung cancer: a pilot study

“…ADC change after therapy has proven prognostic of overall survival (OS) in a study mixed of patients with SCLC and NSCLC (Tsuchida et al 2013 ). Other studies of patients with NSCLC have confirmed predictive and prognostic value of ADC change during therapy (Weiss et al 2016 ; Yabuuchi et al 2011 ; Yu et al 2014 ), though baseline ADC did not show prognostic value (Usuda et al 2018 ; Yu et al 2014 ).…”

“…FLT-PET has been studied in SCLC xenografts in mice showing promise for early response evaluation of treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKI) (Pardo et al 2009 ), but we are unaware of any studies of FLT-PET in patients with SCLC. In patients with non-small cell lung cancer (NSCLC), pretreatment FLT-PET/CT and FLT-PET/CT early after treatment start has shown prognostic value (Yap et al 2006 ; Brockenbrough et al 2011 ; Usuda et al 2018 ; Kahraman et al 2012 ; Trigonis et al 2014 ). Early response evaluation measured by FLT-PET/CT was prognostic for progression-free survival (PFS) in patients with NSCLC treated with EGFR TKI (Kahraman et al 2011 ; Mileshkin et al 2011 ; Sohn et al 2008 ).…”