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General Clinical Specialties: General Practice-OncologyLung Malignancies |
1 Nuclear Medicine; 2 Pulmonology; 3 Radiology, Chonnam National University Hospital, Gwang-ju, South Korea
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Objectives: There were unusual findings that FDG uptake of primary tumor increased while tumoral size decreased for restaging non-small cell lung cancer (NSCLC). The aim of this study was to compare prognosis between FDG uptake-size match and mismatch by comparing staging and restaging F-18 FDG PET/CT (PET/CT).
Methods: Twenty patients with advanced NSCLC (stage > IIIB) were involved in this study. They underwent PET/CT for staging and restaging after 1st line chemo- and/or radiation therapy, respectively. We measured size of primary tumor from CT and maximum SUV (maxSUV) from PET and compared them. We grouped patients into those who showed significant improvement in both CT and PET (FDG uptake-size match, group 1) and those who showed significant improvement in CT but aggravation in PET (FDG uptake–size mismatch, group 2). We compared prognosis by estimating survival rate according to Kaplan-Meier (P < 0.05).
Results: Among them, there were 15 patients in group 1 and 5 patients in group 2. There was no difference between the size or FDG uptake in PET/CT for staging (P > 0.05). In Kaplan-Meier survival plot, group 1 showed prolonged survival (median survival, 731 vs 314 days) and difference in survival between the 2 groups was significant (P < 0.05). However, difference in disease-free survival between them was not significant, although group 2 showed shorter interval of relapse.
Conclusions: For restaging NSCLC, survival rate was significantly low in group with FDG uptake-size mismatch. Therefore, we need to decide the next management by considering change of FDG uptake, although tumoral size decreases.
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