F-18 FDG uptake on positron emission tomography as a predictor for lymphovascular invasion in patients with lung adenocarcinoma.
OBJECTIVE
To evaluate the contributory value of Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in the prediction of lymphovascular tumor invasion in patients with lung adenocarcinoma.


METHODS
We evaluated F-18 FDG-PET/CT images in 84 patients with histopathologically proven lung adenocarcinoma (37 men and 47 women, age range 39-83 years, mean age 67.0 ± 8.9 years). The maximum standardized uptake values (SUVmax) of the carcinomas were measured from the PET images. The Mann-Whitney U test was conducted to compare the median SUVmax between the tumor groups with and without lymphovascular invasion. In the subgroup patients with no lymph-node metastasis, we also compared the median SUVmax between the tumor groups with and without lymphatic invasion.


RESULTS
The tumors with lymphovascular invasion had a significantly (P < 0.0001) greater median SUVmax than those without invasion. In the subgroup patients with no lymph-node metastasis, the median SUVmax was higher in tumors with lymphatic invasion than those without (P = 0.0004). The sensitivity, specificity, and area under the receiver operating characteristic curve for the detection of tumors with lymphovascular invasion were 89, 75 %, and 0.82, respectively, with a cutoff SUVmax value of 2.32.


CONCLUSIONS
The SUVmax of lung adenocarcinoma is a potential imaging biomarker for predicting tumor lymphovascular invasion.
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Yoshifumi
Y
Noda
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan. gossy@par.odn.ne.jp.
Satoshi
S
Goshima
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.|Departments of Radiology Services, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Masayuki
M
Kanematsu
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Haruo
H
Watanabe
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Hiroshi
H
Kawada
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Nobuyuki
N
Kawai
Departments of Radiology, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Hiromi
H
Ono
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Kyongtae T
KT
Bae
D000230:Adenocarcinoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18
F-18 FDG-PET/CT; Lung adenocarcinoma; Lymphovascular invasion; SUVmax