Integrated PET/CT of pulmonary neuroendocrine tumors: diagnostic and prognostic implications.
OBJECTIVE
The purpose of this study was to describe retrospectively integrated PET/CT findings on pulmonary neuroendocrine tumors and to correlate the findings with prognosis.


METHODS
Between May 2003 and February 2005, 37 consecutively enrolled patients (33 men and four women; mean age, 60 years) with histopathologically proven pulmonary neuroendocrine tumors underwent 18F-FDG PET/CT after enhanced standalone CT. CT was used to analyze the morphologic features of the tumors and PET to measure maximum standardized uptake value (SUV). Maximum SUVs of carcinoid tumors, large-cell neuroendocrine carcinomas (LCNECs), and small-cell lung carcinomas (SCLCs) were compared, and maximum SUV and tumor stage and prognosis were correlated.


RESULTS
Four (two typical and two atypical) of the seven carcinoid tumors had no FDG uptake or less than mediastinal uptake. The maximum SUVs of primary tumors, in increasing order, were significantly different for carcinoids (mean, 4.0; median, 3.4), LCNECs (mean, 12.0; median, 10.7), and SCLCs (mean, 11.6; median, 11.7) (p = 0.006, Kruskal-Wallis test). There was no significant correlation between maximum SUV of the primary tumor and the tumor stages of carcinoids, LCNECs, or SCLCs (p = 0.08, Jonckheere-Terpstra test; p = 0.768, Mann-Whitney test). Results of receiver operating characteristics analysis showed a maximum SUV greater than 13.7 suggested a poor survival period in cases of LCNEC and SCLC.


CONCLUSIONS
The maximum SUVs of neuroendocrine tumors are significantly different for carcinoid tumors, LCNECs, and SCLCs, and a high maximum SUV suggests short survival of patients with LCNEC or SCLC.
Chong
Semin
S
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Kangnam-gu, Seoul, South Korea, 135-710.
Lee
Kyung Soo
KS
Kim
Byung-Tae
BT
Choi
Joon Young
JY
Yi
Chin A
CA
Chung
Myung Jin
MJ
Oh
Dae-Kun
DK
Lee
Ji-Young
JY
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18