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.
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.
Murakami
Shuji
S
Department of Thoracic Oncology, Kanagawa Cancer Center Hospital, Nakao 1-1-2, Asahi-ku, Yokohama 241-0815, Japan. murakamis@kcch.jp
Saito
Haruhiro
H
Sakuma
Yuji
Y
Mizutani
Yumiko
Y
Ishikawa
Yoshihiro
Y
Kondou
Tetsuro
T
Oshita
Fumihiro
F
Yokose
Tomoyuki
T
Kameda
Youichi
Y
Suga
Yasuhiro
Y
Ito
Hiroyuki
H
Tsuboi
Masahiro
M
Nakayama
Haruhiko
H
Noda
Kazumasa
K
Yamada
Kouzo
K
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
D019394:Ki-67 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18