title: SUVmax and Tumour Location in PET-CT Predict Oncogene Status in Lung Cancer.
abstract: BACKGROUND
  In non-small cell lung cancer, anaplastic lymphoma kinase gene rearrangement (ALK+) and epidermal growth factor receptor mutations (EGFR+) are targetable with tyrosine kinase inhibitors.
  
  
  METHODS
  27 patients with ALK+ tumours, who underwent positron emission tomography-computed tomography (PET-CT) prior to any treatment, were identified. 2 equally sized control groups based on consecutive patients with EGFR+ and EGFR/ALK wild-type (wt) were identified. The maximum standardized uptake value (SUVmax), tumour location (central vs. peripheral), as well as patient- and disease-specific characteristics were collected.
  
  
  RESULTS
  Mutation status was significantly associated with SUVmax (p < 0.008). The median SUVmax of the primary tumour in the lung for ALK+ patients (SUVmax 13) was significantly higher compared to that of the EGFR+ (SUVmax 9.8, p = 0.010) and the EGFR/ALKwt group (SUVmax 9.6, p = 0.022). No difference was observed between the EGFR+ and the EGFR/ALKwt group (p = 0.961). Mutation status was also associated with primary tumour location (p = 0.001). There was a significantly lower rate of central tumours in the EGFR+ group when compared to ALK+ tumours (15%, p = 0.002). Among EGFR/ALKwt tumours, 41% were central compared to 63% of ALK+ tumours (p = 0.235).
  
  
  CONCLUSIONS
  On initial PET-CT, ALK+ primary lung tumours showed a higher SUVmax and were more frequently centrally located while peripheral tumours were more likely to be EGFR+.
authors.affiliation: Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Putora
authors.forename: Kinga
authors.initials: K
authors.lastname: Szentesi
authors.forename: Markus
authors.initials: M
authors.lastname: Glatzer
authors.forename: Regulo
authors.initials: R
authors.lastname: Rodriguez
authors.forename: Joachim
authors.initials: J
authors.lastname: Müller
authors.forename: Florent
authors.initials: F
authors.lastname: Baty
authors.forename: Martin
authors.initials: M
authors.lastname: Früh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000235:genetics*; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005819:Genetic Markers / Q000235:genetics; D020022:Genetic Predisposition to Disease; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009857:Oncogenes / Q000235:genetics; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D005819:Genetic Markers; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases