FDG PET in the evaluation of the aggressiveness of pulmonary adenocarcinoma: correlation with histopathological features

Abstract

2-[Fluorine-18]fluoro-2-deoxy-d-glucose (FDG) uptake within the primary lesion correlates with survival on positron emission tomography (PET) studies of patients with non-small cell lung cancer. The more metabolically active the tumour, the worse the outcome. The aim of this study was to determine whether a correlation exists between aggressiveness as determined by pathology and the findings of FDG PET in pulmonary adenocarcinoma. Thirty-five patients with 38 adenocarcinomas of the lung were studied. All patients underwent thoracotomy within 4 weeks of the FDG PET study. For semiquantitative analysis, standardized uptake values (SUVs) were calculated. Patients were classified into high SUV (> or = 4.0) and low SUV (<4.0) groups. The degree of FDG uptake (SUVs) in primary lung lesions was correlated with the histopathological features of aggressiveness (pleural involvement, vascular invasion or lymphatic permeation). The mean SUV of aggressive adenocarcinomas (4.36+/-1.94, n = 22) was higher than that of non-aggressive ones (1.53+/-0.88, n = 16) (P < 0.0001). Tumours with a high FDG uptake have a significantly higher likelihood of aggressiveness than those with a low FDG uptake (P = 0.0004). Analysis by the Kaplan-Meier methods revealed that the groups had different prognoses (log-rank test, P = 0.0099). The high SUV group had a significantly worse prognosis. In conclusion, a correlation was seen between aggressiveness as determined by pathology and glucose metabolism as measured by FDG PET in adenocarcinoma of the lung. FDG PET may be used as a non-invasive diagnostic technique in measuring aggressiveness and prognosis in patients with pulmonary adenocarcinoma.

Comparison between positron emission tomography and computed tomography in the use of the assessment of esophageal carcinoma

“…In pulmonary adenocarcinoma, it has been reported that cases with high FDG uptake have a lower 5-year survival rate than those with a low FDG uptake, and also show poorer prognosis. 11 In addition, in nonsmall cell lung carcinoma, it has been reported that FDG uptake is an independent prognostic factor, giving values similar to those obtained from pathologic staging. 9 Uptake of FDG has been shown to correlate with the proliferative rate in lung carcinoma.…”

“…[7][8][9][10][11] Markedly increased FDG uptake in esophageal squamous cell carcinoma (SCC) has been documented in several studies, [12][13][14][15] and they have reported that PET using FDG shows greater sensitivity in the diagnosis of involved regional lymph nodes than computed tomography (CT). This suggests that PET may have a role in evaluating the stage of esophageal carcinoma.…”

Predictive value of 18F-fluorodeoxyglucose positron emission tomography - computed tomography compared to postoperative pathological findings for patients with non-small-cell lung cancer

“…In addition, the uptake of FDG in the primary tumor reflects some biological information, including proliferative activity (20), tumor doubling time (21), microvessel density (22), histological subtype (17,18) and tumor grading (17). In the present study, the FDG uptake and MTV of the primary tumor were significantly different among subgroups by differentiation in both AC and SCC.…”

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

“…In another study this group found that those adenocarcinomas with more invasive features (i.e. poorly differentiated tumors) had greater FDG uptake (SUV 4.36±1.94) compared to non-invasive tumors (SUV 1.53±0.88) (22). Additionally, they found that patients with tumors with greater FDG uptake had a poorer prognosis.…”