The Maximum Standardized FDG Uptake on PET/CT in Evaluation of Patients with Non-small Cell Lung Cancer: A Prospective Study
Rania Abdalrahman Albahnasy
Radiodiagnosis Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Manal Fathey Hamisa
Radiodiagnosis Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Fatma Gharib Khirallah
Oncology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Hwaida M. Mokhtar
Radiodiagnosis Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) functional imaging has shown to be an invaluable non-invasive, diagnostic method, enhancing the accuracy in the presenting of Non-Small Cell Lung Cancer (NSCLC). The purpose of this research was to evaluate the role of the maximum standardized uptake value (SUV max) in PET-CT in staging and follow-up of operable and non-operable patients with NSCLC.
Methods: This prospective research carried on 50 cases with histopathological diagnosis of NSCLC were mentioned to do PET/CT scanning for initial staging of the disease (17 patients died, 28 survived, and five were lost to follow-up so 28 patients out of 50 came for follow-up after treatment with surgery, radiotherapy, or chemotherapy). All cases underwent intravenous contrast media, 18F-FDG Dosage Administration, CT Technique, PET Technique, PET-CT Fusion, and PET/CT Interpretation.
Results: SUV max is a semi-quantitative technique of determining 18F-FDG uptake by tumor cells. Adenocarcinomas have lower 18F-FDG uptake and lower SUV max measurements compared to the squamous cell carcinoma. The average SUVs of tumours ≥ 4 were significant increased compared to those < 4, and additional analysis showed that SUV max was significantly correlated with tumor size. SUV max is a prognostic factor of T and N stages as T1 lesions had a decrease average SUV max compared to T2 and a lower mean SUV max than T3/T4 lesions, also we found that the mean SUV max of N0 is lower compared to that of NI, NII, and lower than NIII. There was a strong association among ΔSUV and Δ size.
Conclusion: FDG-PET/CT was a valuable, efficient, and reliable method of analysis in the initial staging and follow-up of lung cancer cases, and lately became a portion of the international standards in the diagnosis and the follow-up of cases with bronchogenic carcinoma.
Keywords: NSCLC, FDG, PET/CT