Impacts of 18 F-FDG PET/CT Parameters on Differential Diagnosis and Outcome of Patients with Primary Invasive Mucinous and Lepidic Predominant Adenocarcinoma of the Lung


Tatci E., Ozmen O., Kizilgoz D., Demirag F., Bilgic S.

MOLECULAR IMAGING AND RADIONUCLIDE THERAPY, cilt.33, sa.3, ss.147-155, 2024 (ESCI) identifier identifier identifier identifier

Özet

Objectives: The purpose of this study was to investigate whether18F-fluorodeoxyglucose 18 F-fluorodeoxyglucose (18F-FDG) 18 F-FDG) positron emission tomography/computed tomography (PET/CT) parameters have a role in differentiating invasive mucinous lung adenocarcinoma (IMA) from lepidic predominant lung adenocarcinoma (LPA). Additionally, we compared the18F-FDG-PET/CT 18 F-FDG-PET/CT features between survivors and non-survivors. Methods: Tumors were divided into 2 groups according to CT appearance: Group 1: nodular-type tumor; group 2: mass- or pneumonic-type tumor. Unilateral and bilateral multifocal diseases were detected. Clinicopathological characteristics and PET/CT findings were compared between IMAs and LPAs, as well as between survivors and non-survivors. Results: We included 43 patients with IMA and 14 with LPA. Tumor size (p=0.003), incidence of mass/pneumonic type (p=0.011), and bilateral lung involvement (p=0.049) were higher in IMAs than in LPAs. IMAs had more advanced T, M, and Tumor, Node, and Metastasis stages than in LPAs (p=0.048, p=0.049, and p=0.022, respectively). There was no statistically significant difference in maximum standardized uptake value (SUVmax) max ) between the IMA and LPA (p=0.078). The SUV was significantly lower in the nodular group than in the mass/pneumonic-type group (p=0.0001). A total of 11 patients died, of whom SUVmax max values were significantly higher in these patients (p=0.031). Male gender (p=0.0001), rate of stage III-IV (p=0.0001), T3-T4 (p=0.021), M1 stages (p=0.0001), multifocality (p=0.0001), and bilateral lung involvement (p=0.0001) were higher in non-survivor. Conclusions: Although CT images were useful for the differential diagnosis of LPAs and IMAs, SUVmax max was not helpful for differentiation of these 2 groups. However, both18F-FDG 18 F-FDG uptake and CT findings may play an important role in predicting prognosis in these patients.