title: Imaging characteristics of stage I non-small cell lung cancer on CT and FDG-PET: relationship with epidermal growth factor receptor protein expression status and survival.
abstract: OBJECTIVE
  To identify CT and FDG-PET features associated with epidermal growth factor receptor (EGFR) protein overexpression, and to evaluate whether imaging features and EGFR-overexpression can help predict clinical outcome.
  
  
  METHODS
  In 214 patients (M : F = 129 : 85; mean age, 63.2) who underwent curative resection of stage I non-small cell lung cancer, EGFR protein expression status was determined through immunohistochemical analysis. Imaging characteristics on CT and FDG-PET was assessed in relation to EGFR-overexpression. Imaging features and EGFR-overexpression were also evaluated for clinical outcome by using the Cox proportional hazards model.
  
  
  RESULTS
  EGFR-overexpression was found in 51 patients (23.8%). It was significantly more frequent in tumors with an SUV(max) > 5.0 (p < 0.0001), diameter > 2.43 cm (p < 0.0001), and with ground glass opacity ≤ 50% (p = 0.0073). SUV(max) > 5.0 (OR, 3.113; 95% CI, 1.375-7.049; p = 0.006) and diameter > 2.43 cm (OR, 2.799; 95% CI, 1.285-6.095; p = 0.010) were independent predictors of EGFR overexpression. Multivariate analysis showed that SUV(max) > 4.0 (hazard ratio, 10.660; 95% CI, 1.370-82.966; p = 0.024), and the presence of cavitation within a tumor (hazard ratio, 3.122; 95% CI, 1.143-8.532; p = 0.026) were factors associated with poor prognosis.
  
  
  CONCLUSIONS
  EGFR-overexpression is associated with high SUV(max), large tumor diameter, and small GGO proportion. CT and FDG-PET findings, which are closely related to EGFR overexpression, can be valuable in the prediction of clinical outcome.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea.
authors.forename: Youkyung
authors.initials: Y
authors.lastname: Lee
authors.forename: Hyun-Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kang
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Jin Chul
authors.initials: JC
authors.lastname: Paeng
authors.forename: Doo Hyun
authors.initials: DH
authors.lastname: Chung
authors.forename: Yoon Kyung
authors.initials: YK
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D016009:Chi-Square Distribution; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D016016:Proportional Hazards Models; D012372:ROC Curve; D019275:Radiopharmaceuticals; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D066246:ErbB Receptors
keywords: CT; EGFR; EGFR protein; FDG-PET; Non-small cell lung cancer