Correlation of F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value and EGFR mutations in advanced lung adenocarcinoma.
OBJECTIVE
Epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma are involved in the tumorigenesis and regulation of cell metabolism via Akt signaling. F-18 fluorodeoxyglucose-positron emission tomography ([(18)F]FDG PET), a functional imaging modality, can be used to measure tumor cell metabolism. Thus, in this study, we hypothesize that there exist correlations between EGFR mutation status and [(18)F]FDG uptake of advanced lung adenocarcinoma.


METHODS
From May 2004 to April 2008, patients with stage IIIB or IV lung adenocarcinoma who underwent [(18)F]FDG PET and EGFR mutation analysis before receiving any treatment were eligible to participate in this study. The association of EGFR mutation status with patient characteristics and the SUV(MAX) from the [(18)F]FDG PET was evaluated. Multivariate logistic regression analysis was used to analyze predictors of EGFR mutations.


RESULTS
Seventy-seven lung adenocarcinoma patients were included in this study. EGFR mutations were identified in 49 (64%) of the patients. The [(18)F]FDG uptake was significantly higher in EGFR-mutant (mean SUV(MAX) = 10.5 +/- 4.7) than wild-type (8.0 +/- 3.3) lung adenocarcinoma patients (P = 0.008). The median SUV(MAX) was 9.5, and patients with an SUV(MAX) >or= 9.5 were more likely to harbor EGFR mutations (P = 0.009). In the multivariate analysis, an SUV(MAX) >or= 9.5 remained a statistically significant predictor of EGFR mutations (P = 0.005).


CONCLUSIONS
Among Asian patients with advanced lung adenocarcinoma, those with higher SUV(MAX) on the [(18)F]FDG PET are more likely to carry EGFR mutations.
Huang
Chun-Ta
CT
Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Br., Yun-Lin County, Taiwan.
Yen
Rouh-Fang
RF
Cheng
Mei-Fang
MF
Hsu
Ya-Chieh
YC
Wei
Pin-Fei
PF
Tsai
Yi-Ju
YJ
Tsai
Meng-Feng
MF
Shih
Jin-Yuan
JY
Yang
Chih-Hsin
CH
Yang
Pan-Chyr
PC
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000235:genetics* / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004273:DNA, Neoplasm / Q000032:analysis / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005820:Genetic Testing; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals
D004273:DNA, Neoplasm; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C512478:EGFR protein, human; D066246:ErbB Receptors