title: Noninvasive evaluation of microscopic tumor extensions using standardized uptake value and metabolic tumor volume in non-small-cell lung cancer.
abstract: OBJECTIVE
  To prospectively evaluate whether maximal microscopic extensions (MEmax) correlate with maximal standardized uptake value (SUVmax) and metabolic tumor volume (MTV) at 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) images in non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Thirty-nine patients with Stage I-IIIA NSCLC underwent surgery after FDG-PET/CT scanning. SUVmax and MTV were calculated on the PET/CT images. The maximum linear distance from the tumor margin to the farthest extent of the tumor in every dimension was measured at the tumor section. The correlations among MEmax, SUVmax, MTV and other clinical pathologic parameters were analyzed.
  
  
  RESULTS
  MEmax for all patients had a significant correlation with SUVmax (r = 0.777, p = 0.008) and MTV (r = 0.724, p < 0.001). When expressed in terms of the probability of covering ME with respect to a given margin, we suggested that margins of 1.93 mm, 3.90 mm, and 9.60 mm for SUVmax ≤ 5, 5-10, and >10 added to the gross tumor volume would be adequate to cover 95% of ME.
  
  
  CONCLUSIONS
  This study demonstrated that tumors with high SUVmax and MTV have more MEmax and would therefore require more margin expansion from gross tumor volume to clinical target volume. FDG-PET/CT, especially for SUVmax, is promising and effective and merits additional study in noninvasive delimiting of the clinical target volume margin for NSCLC.
authors: Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Shandong University, Jinan, China.
authors: Xue
authors: X
authors: Meng
authors: Xindong
authors: X
authors: Sun
authors: Dianbin
authors: D
authors: Mu
authors: Ligang
authors: L
authors: Xing
authors: Li
authors: L
authors: Ma
authors: Baijiang
authors: B
authors: Zhang
authors: Shuqiang
authors: S
authors: Zhao
authors: Guoren
authors: G
authors: Yang
authors: Feng-Ming Spring
authors: FM
authors: Kong
authors: Jinming
authors: J
authors: Yu
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D059016:Tumor Microenvironment
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18