Login Register Cart 0
Generic placeholder image

Current Radiopharmaceuticals

Editor-in-Chief

ISSN (Print): 1874-4710
ISSN (Online): 1874-4729

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

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

Author(s): Ozan Kandemir* and Fadime Demir

Volume 17, Issue 1, 2024

Published on: 01 September, 2023

Page: [111 - 116] Pages: 6

DOI: 10.2174/1874471016666230829100703

Price: $65

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.

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.

« Previous Next »
Graphical Abstract

[1]
Thai, A.A.; Solomon, B.J.; Sequist, L.V.; Gainor, J.F.; Heist, R.S. Lung cancer. Lancet, 2021, 398(10299), 535-554.
[http://dx.doi.org/10.1016/S0140-6736(21)00312-3] [PMID: 34273294]
[2]
Hua, J.; Li, L.; Liu, L.; Liu, Q.; Liu, Y.; Chen, X. The diagnostic value of metabolic, morphological and heterogeneous parameters of 18F-FDG PET/CT in mediastinal lymph node metastasis of non–small cell lung cancer. Nucl. Med. Commun., 2021, 42(11), 1247-1253.
[http://dx.doi.org/10.1097/MNM.0000000000001456] [PMID: 34269750]
[3]
Ettinger, D.S.; Wood, D.E.; Aisner, D.L.; Akerley, W.; Bauman, J.; Chirieac, L.R.; D’Amico, T.A.; DeCamp, M.M.; Dilling, T.J.; Dobelbower, M.; Doebele, R.C.; Govindan, R.; Gubens, M.A.; Hennon, M.; Horn, L.; Komaki, R.; Lackner, R.P.; Lanuti, M.; Leal, T.A.; Leisch, L.J.; Lilenbaum, R.; Lin, J.; Loo, B.W., Jr; Martins, R.; Otterson, G.A.; Reckamp, K.; Riely, G.J.; Schild, S.E.; Shapiro, T.A.; Stevenson, J.; Swanson, S.J.; Tauer, K.; Yang, S.C.; Gregory, K.; Hughes, M. Non-small cell lung cancer, Version 5.2017, NCCN clinical practice guidelines in oncology. J. Natl. Compr. Canc. Netw., 2017, 15(4), 504-535.
[http://dx.doi.org/10.6004/jnccn.2017.0050] [PMID: 28404761]
[4]
Farsad, M. FDG PET/CT in the staging of lung cancer. Curr. Radiopharm., 2020, 13(3), 195-203.
[http://dx.doi.org/10.2174/1874471013666191223153755] [PMID: 31868151]
[5]
Suh, Y.J.; Park, C.M.; Han, K.; Jeon, S.K.; Kim, H.; Hwang, E.J.; Lee, J.H.; Paeng, J.C.; Lee, C.H.; Kim, Y.T.; Goo, J.M. Utility of FDG PET/CT for preoperative staging of non -small cell lung cancers manifesting as subsolid nodules with a solid portion of 3 cm or smaller. AJR Am. J. Roentgenol., 2020, 214(3), 514-523.
[http://dx.doi.org/10.2214/AJR.19.21811] [PMID: 31846374]
[6]
Kandathil, A.; Kay, F.; Butt, Y.; Wachsmann, J.; Subramaniam, R. Role of FDG PET/CT in the eighth edition of TNM staging of nonsmall cell lung cancer. Radiographics., 2018, 38(7), 2134-2149.
[7]
Akdemir, Ü.Ö.; Aydos, U. Role of fluorodeoxyglucose positron emission tomography computed tomography imaging in diagnosis and staging of lung cancer. Nuclear. Medical Seminars, 2018, 4(1), 6-17.
[http://dx.doi.org/10.4274/nts.2018.002]
[8]
Kaseda, K.; Asakura, K.; Kazama, A.; Ozawa, Y. Risk factors for predicting occult lymph node metastasis in patients with clinical stage I non-small cell lung cancer staged by integrated fluorodeoxyglucose positron emission tomography/computed tomography. World J. Surg., 2016, 40(12), 2976-2983.
[http://dx.doi.org/10.1007/s00268-016-3652-5] [PMID: 27456499]
[9]
Li, L.; Ren, S.; Zhang, Y.; Guan, Y.; Zhao, J.; Liu, J.; Wang, Q.; Chen, G.; Chen, H.; Xiang, J.; Fu, X. Risk factors for predicting the occult nodal metastasis in T1–2N0M0 NSCLC patients staged by PET/CT: Potential value in the clinic. Lung Cancer, 2013, 81(2), 213-217.
[http://dx.doi.org/10.1016/j.lungcan.2013.04.012] [PMID: 23664030]
[10]
Lin, J.; Yang, X.; Zhong, W.; Liao, R.; Dong, S.; Nie, Q.; Weng, S.; Fang, X.; Zheng, J.; Wu, Y. Association of maximum standardized uptake value with occult mediastinal lymph node metastases in cN0 non-small cell lung cancer. Eur. J. Cardiothorac. Surg., 2016, 50(5), 914-919.
[http://dx.doi.org/10.1093/ejcts/ezw109] [PMID: 27113090]
[11]
Smeltzer, M.P.; Faris, N.R.; Ray, M.A.; Osarogiagbon, R.U. Association of pathologic nodal staging quality with survival among patients with non–small cell lung cancer after resection with curative intent. JAMA Oncol., 2018, 4(1), 80-87.
[http://dx.doi.org/10.1001/jamaoncol.2017.2993] [PMID: 28973110]
[12]
Pak, K.; Kim, K.; Kim, M.H.; Eom, J.S.; Lee, M.K.; Cho, J.S.; Kim, Y.S.; Kim, B.S.; Kim, S.J.; Kim, I.J. A decision tree model for predicting mediastinal lymph node metastasis in non-small cell lung cancer with F-18 FDG PET/CT. PLoS One, 2018, 13(2), e0193403.
[http://dx.doi.org/10.1371/journal.pone.0193403] [PMID: 29486012]
[13]
Ose, N.; Sawabata, N.; Minami, M.; Inoue, M.; Shintani, Y.; Kadota, Y.; Okumura, M. Lymph node metastasis diagnosis using positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose as a tracer and computed tomography in surgical cases of non-small cell lung cancer. Eur. J. Cardiothorac. Surg., 2012, 42(1), 89-92.
[http://dx.doi.org/10.1093/ejcts/ezr287] [PMID: 22290887]
[14]
Soret, M.; Bacharach, S.L.; Buvat, I. Partial-volume effect in PET tumor imaging. J. Nucl. Med., 2007, 48(6), 932-945.
[http://dx.doi.org/10.2967/jnumed.106.035774] [PMID: 17504879]
[15]
García de Castro, B.A.; Domínguez, F.J.; Bolton, D.R.; Fernández, P.C.; Cabeza, M.B.; García-Esquinas, G.M.; Delgado, C.J.L. PET-CT in presurgical lymph node staging in non-small cell lung cancer: The importance of false-negative and false-positive findings. Radiology, 2017, 59(2), 147-158.
[http://dx.doi.org/10.1016/j.rxeng.2016.12.005] [PMID: 28238444]
[16]
Lilo, M.T.; Allison, D.B.; Younes, B.K.; Cui, M.; Askin, F.B.; Gabrielson, E.; Li, Q.K. The critical role of EBUS‐TBNA cytology in the staging of mediastinal lymph nodes in lung cancer patients: A correlation study with positron emission tomography findings. Cancer Cytopathol., 2017, 125(9), 717-725.
[http://dx.doi.org/10.1002/cncy.21886] [PMID: 28609021]
[17]
Lu, P.; Sun, Y.; Sun, Y.; Yu, L. The role of 18F-FDG PET/CT for evaluation of metastatic mediastinal lymph nodes in patients with lung squamous-cell carcinoma or adenocarcinoma. Lung Cancer, 2014, 85(1), 53-58.
[http://dx.doi.org/10.1016/j.lungcan.2014.04.004] [PMID: 24792334]
[18]
Madsen, P.H.; Holdgaard, P.C.; Christensen, J.B.; Høilund-Carlsen, P.F. Clinical utility of F-18 FDG PET-CT in the initial evaluation of lung cancer. Eur. J. Nucl. Med. Mol. Imaging, 2016, 43(11), 2084-2097.
[http://dx.doi.org/10.1007/s00259-016-3407-4] [PMID: 27164899]
[19]
Shen, B.; Huang, T.; Sun, Y.; Jin, Z.; Li, X.F. Revisit 18F-fluorodeoxyglucose oncology positron emission tomography: “Systems molecular imaging” of glucose metabolism. Oncotarget, 2017, 8(26), 43536-43542.
[http://dx.doi.org/10.18632/oncotarget.16647] [PMID: 28402949]
[20]
Al-Ibraheem, A.; Hirmas, N.; Fanti, S.; Paez, D.; Abuhijla, F.; Al-Rimawi, D.; Al-Rasheed, U.; Abdeljalil, R.; Hawari, F.; Alrabi, K.; Mansour, A. Impact of 18F-FDG PET/CT, CT and EBUS/TBNA on preoperative mediastinal nodal staging of NSCLC. BMC Med. Imaging, 2021, 21(1), 49.
[http://dx.doi.org/10.1186/s12880-021-00580-w] [PMID: 33731050]
[21]
Ouyang, M.; Tang, K.; Xu, M.; Lin, J.; Li, T.; Zheng, X. Prediction of occult lymph node metastasis using tumor-to-blood standardized uptake ratio and metabolic parameters in clinical N0 lung adenocarcinoma. Clin. Nucl. Med., 2018, 43(10), 715-720.
[http://dx.doi.org/10.1097/RLU.0000000000002229] [PMID: 30106864]
[22]
Satoh, Y.; Onishi, H.; Nambu, A.; Araki, T. Volume-based parameters measured by using FDG PET/CT in patients with stage I NSCLC treated with stereotactic body radiation therapy: prognostic value. Radiology, 2014, 270(1), 275-281.
[http://dx.doi.org/10.1148/radiol.13130652] [PMID: 24029640]
[23]
Wang, X.Y.; Zhao, Y.F.; Liu, Y.; Yang, Y.K.; Wu, N. Prognostic value of metabolic variables of [18F]FDG PET/CT in surgically resected stage I lung adenocarcinoma. Medicine, 2017, 96(35), e7941.
[http://dx.doi.org/10.1097/MD.0000000000007941] [PMID: 28858121]
[24]
Sharma, A.; Mohan, A.; Bhalla, A.S.; Sharma, M.C.; Vishnubhatla, S.; Das, C.J.; Pandey, A.K.; Sekhar Bal, C.; Patel, C.D.; Sharma, P.; Agarwal, K.K.; Kumar, R. Role of various metabolic parameters derived from baseline 18F-FDG PET/CT as prognostic markers in non-small cell lung cancer patients undergoing platinum-based chemotherapy. Clin. Nucl. Med., 2018, 43(1), e8-e17.
[http://dx.doi.org/10.1097/RLU.0000000000001886] [PMID: 29112011]
[25]
Jin, F.; Qu, B.; Fu, Z.; Zhang, Y.; Han, A.; Kong, L.; Yu, J. Prognostic value of metabolic parameters of metastatic lymph nodes on 18 F-FDG PET/CT in patients with limited-stage small-cell lung cancer with lymph node involvement. Clin. Lung Cancer, 2018, 19(1), e101-e108.
[http://dx.doi.org/10.1016/j.cllc.2017.06.006] [PMID: 28690012]
[26]
Nakanishi, K.; Nakamura, S.; Sugiyama, T.; Kadomatsu, Y.; Ueno, H.; Goto, M.; Ozeki, N.; Fukui, T.; Iwano, S.; Chen-Yoshikawa, T.F. Diagnostic utility of metabolic parameters on FDG PET/CT for lymph node metastasis in patients with cN2 non-small cell lung cancer. BMC Cancer, 2021, 21(1), 983-991.
[http://dx.doi.org/10.1186/s12885-021-08688-6] [PMID: 34474680]
[27]
Cheng, G.; Huang, H. Prognostic value of 18F-Fluorodeoxyglucose PET/computed tomography in non-small- cell lung cancer. PET Clin., 2018, 13(1), 59-72.
[http://dx.doi.org/10.1016/j.cpet.2017.08.006] [PMID: 29157386]

Rights & Permissions Print Cite
Article Metrics
11
1
© 2024 Bentham Science Publishers | Privacy Policy