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J Nucl Med. 2008; 49 (Supplement 1):11P
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General Clinical Specialties: General Practice-Oncology

Lung Malignancies

Clinical significance of histological differences of FDG PET activity in stage I non-small cell lung cancers (NSCLC)

Ishani Dalal1, Bhavin Dalal1, Bingfeng Tang1, Paresh Mahajan1, John Rydberg1, Dafang Wu1, Ishmael Jaiyesimi2, Darlene Fink-Bennett1, Conrad Nagle1 and Ching-yee Wong1

1 Nuclear Medicine; 2 Medical Oncology, William Beaumont Hospital, Royal Oak, Michigan

44

Objectives: To investigate metabolic differences in various histological types of stage I NSCLC and their potential implications on treatment (Tx) and prognosis.

Methods: Staging FDG PET scans of 40 pts (age=73±8; M:F=24:16) with histopathologic Dx of NSCLC receiving definitive Tx (surgery:33; chemoradiation: 7) and follow-up (mean:137 months) were analyzed. PET scans were obtained 1.5 hr after injection of average of 15 mCi of F-18 FDG with CT attenuation correction. The glucose was monitored just before injection and the maximal SUVs (tumor activity/dose per lean body mass) were measured over the primary tumor together with size. Boxplot and ANOVA tests including post-hoc analysis were used with p<0.05 being significant.

Results: There were 24, 13 and 3 pts Dx for adenocarcinoma (ACa), squamous cell cancers (SCC) and NSCLC respectively with mean CT sizes of (2.8±1.5) x (3.0±1.2) cm and pathological size of 3.4±1.3 cm for surgical cases. ANOVA test suggested significant difference of SUV among the histological types (p=0.02). Post-hoc analysis with Tukey (p=0.03) and Scheffe (p=0.039) tests revealed major differences of SUV between SCC and ACa. The SUV of ACa was significantly lower than that of SCC (8.7±6.7 vs 15.1±6.8, p=0.009). However there were no differences in recurrence rates among ACa and SCC pts (33% vs 31% respectively).

Conclusions: Contrast to the clinical belief of possible favorable prognosis of SCC among NSCLC, SCC has a higher SUV than ACa at early presentation. Prognostic studies and new Tx trials (including VEGF like Bevacizumab) using PET(SUV) in NSCLC may need to take into consideration of these histological metabolic variations.





This Article
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Dalal, I.
Right arrow Articles by Wong, C.-y.
PubMed
Right arrow Articles by Dalal, I.
Right arrow Articles by Wong, C.-y.