title: Correlation of 18F-fluorodeoxyglucose uptake on positron emission tomography with Ki-67 index and pathological invasive area in lung adenocarcinomas 30 mm or less in size.
abstract: BACKGROUND
  (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is commonly used to distinguish benign from malignant lesion. Recently, maximum standardized uptake value (SUVmax) on FDG-PET has found to have prognostic value. We examined the relationship between SUVmax and proliferative activities as indicated by maximum diameter of tumor opacity on mediastinal-window images (TOM), Ki-67 index, and diameter of the pathological invasive area in lung adenocarcinomas <or=30 mm.
  
  
  METHODS
  Thin-section computed tomography (TS-CT) and FDG-PET were performed on 140 patients with resectable lung adenocarcinomas <or=30 mm between March 2006 and May 2008. Tumors were classified as air-type or solid-type based on TS-CT findings. In all resected specimens, diameter of the pathological invasive area and Ki-67 index were assessed.
  
  
  RESULTS
  SUVmax was significantly lower for air-type than for solid-type tumors (0.97 vs. 3.96, p<0.0001). In solid-type tumors, SUVmax correlated with diameter of TOM (r=0.450, p<0.0001), Ki-67 index (r=0.567, p<0.0001), and diameter of the pathological invasive area (r=0.672, p<0.0001). In multiple regression analysis, SUVmax correlated significantly with Ki-67 index and diameter of the pathological invasive area but not with diameter of TOM. The cut-off value of SUVmax for predicting invasive area >5mm was determined as 2.15 by ROC analysis, with sensitivity of 88.3% and specificity of 84.6%.
  
  
  CONCLUSIONS
  SUVmax correlated significantly with Ki-67 index and diameter of the pathological invasive area. The present results suggest the potential role of FDG-PET in predicting adenocarcinomas with invasive characteristics.
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center Hospital, Nakao 1-1-2, Asahi-ku, Yokohama 241-0815, Japan. murakamis@kcch.jp
authors.forename: Shuji
authors.initials: S
authors.lastname: Murakami
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Saito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kondou
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Oshita
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yokose
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kameda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Suga
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Noda
authors.forename: Kouzo
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019394:Ki-67 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18