Title:An Investigation of the Relationship Between 18F-FDG PET/CT Parameters
of Primary Tumors and Lymph Node Metastasis in Resectable Non-small
Cell Lung Cancer
Volume: 17
Issue: 1
Author(s): Ozan Kandemir*Fadime Demir
Affiliation:
- Department of Nuclear Medicine, Faculty of Medicine, Sıtkı Kocman University, Mugla, Turkey
Keywords:
Non-small cell lung cancer, lymph node metastasis, 18F-2-fluoro-2-deoxy-D-glucose, positron emission tomography, maximum standardized uptake value, mean standardized uptake.
Abstract:
Background: Mediastinal lymph node metastasis is an important prognostic factor in
non-small cell lung cancer (NSCLC) patients without distant metastases. 18F-2-fluoro-2-deoxy-Dglucose
Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) is recommended
for detecting and staging lymph nodes and distant metastases in NSCLC patients.
Objective: This study aims to investigate whether maximum standardized uptake (SUVmax),
mean standardized uptake (SUVmean), metabolic tumor volume (MTV), and tumor lesion glycolysis
(TLG) values of the primary tumor measured by 18F-FDG PET/CT in resectable NSCLC can
predict preoperative lymph node metastasis.
Methods: This retrospective study included eighty NSCLC patients who underwent preoperative
Positron Emission Tomography/Computed Tomography (PET/CT) for diagnosis and staging. The
patients were stage I-III and had no distant metastases. Tumor metabolic parameters such as SUVmax,
SUVmean, MTV, and TLG at PET/CT imaging were measured for preoperative diagnosis
and staging, and the postoperative pathology results of the patients were examined. The pathology
results divided patients with and without lymph node metastasis into two groups. The groups were
compared with the student's t-test and chi-square test regarding 18F-FDG PET/CT tumor metabolic
parameters and other parameters.
Results: Fifteen (18.8%) patients were female, and 65 (81.3%) were male. According to the postoperative
pathology results, while 30 (37.5%) patients had lymph node metastasis, 50 (62.5%) did
not. There was a significant difference between the groups regarding tumor SUVmax and SUVmean
values (p = 0.036, p = 0.045). Overall survival in the N0 group was significantly higher
than in the N1 + N2 group (p = 0.034); median survival was 30.2 months in N0 cases and 27.3
months in N1 and N2 groups.
Conclusion: SUVmax and SUVmean values are significantly higher in patients with lymph node
metastases than in patients without lymph node metastases, and this finding may provide useful
information for predicting lymph node metastasis in patients with resectable NSCLC.
