Can FDG-PET be used to predict growth of stage I lung cancer?

Tann, M.; Sandrasegaran, K.; Winer-Muram, H.T.; Jennings, S.G.; Welling, M.E.; Fletcher, J.W.

doi:10.1016/j.crad.2008.01.012

« Previous Next »Clinical Radiology
Volume 63, Issue 8 , Pages 856-863, August 2008

Can FDG-PET be used to predict growth of stage I lung cancer?

M. Tann
- Department of Radiology, Indiana University School of Medicine, Indianapolis, USA
K. Sandrasegaran
- Department of Radiology, Indiana University School of Medicine, Indianapolis, USA
- Guarantor and correspondent: K. Sandrasegaran, Department of Radiology, Indiana University School of Medicine, 550 N. University Boulevard, Suite UH0279, Indianapolis, IN 46202, USA. Tel.: +1 (317) 274 8832; fax: +1 (317) 274 1848.
H.T. Winer-Muram
- Department of Radiology, Richard L. Roudebush Veterans' Association Medical Center, Indianapolis, USA
S.G. Jennings
- Department of Radiology, Indiana University School of Medicine, Indianapolis, USA
M.E. Welling
- Department of Radiology, Indiana University School of Medicine, Indianapolis, USA
J.W. Fletcher
- Department of Radiology, Indiana University School of Medicine, Indianapolis, USA

Received 23 May 2007; received in revised form 31 December 2007; accepted 13 January 2008.

Aim

To determine the relationship between the metabolic activity measured by 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) and computed tomography (CT)-derived tumour growth rates for stage 1 lung cancer.

Methods

Stage I lung cancer patients at our institution who underwent FDG PET, and who had at least two pre-treatment chest CT examinations (n=51), were retrospectively identified. Metabolic activity was defined by maximum lesion standardized uptake value (SUV) and maximum lesion-to-mean background activity (LBR). Growth rates were determined from serial CT volume measurements and the doubling time (DT) was calculated. Tumour growth rates were divided into rapid (DT<180 days), intermediate (DT=180–270 days), and slow (DT>270 days) groups.

Results

Rapid, moderate, and slow DT were seen in 22, 19, and 10 patients, respectively. Means (standard deviations) of SUV in the three groups (from rapid to slow growth rate) were 8.2 (4.8), 5.5 (4.5), and 2.2 (1.1), respectively and of LBR were 22.7 (10.1), 15.1 (12.6), and 6 (2.6), respectively. There was a significant relationship between SUV and DT (p<0.05), as well as between LBR and DT (p<0.05).

Conclusions

For stage I lung tumours, there is a significant relationship between growth rates, as measured by serial CT examinations, and the initial pre-treatment metabolic activities, as measured by FDG uptake. This suggests that in patients in whom it is difficult to decide on the aggressiveness on treatment, FDG-PET may be used as additional prognostic tool for determining management.