Document Detail


Value of integrated positron emission tomography revised using a phantom study to evaluate malignancy grade of lung adenocarcinoma: a multicenter study.
MedLine Citation:
PMID:  20564630     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The malignant biological behavior of small-sized lung adenocarcinomas remains obscure, although understanding this feature is important for selecting appropriate treatment. In the current study, the authors evaluated malignancy grades of small adenocarcinomas using fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) in addition to high-resolution CT (HRCT) and pathological analysis in a multicenter setting. METHODS: A total of 201 patients with clinical T1N0M0 adenocarcinoma underwent PET/CT and HRCT followed by complete surgical resection. Associations between components of bronchioloalveolar carcinoma (BAC) in specimens and maximum standardized uptake values (maxSUV) on PET/CT and ground-glass opacity (GGO) ratios and tumor disappearance rate (TDR) on HRCT were analyzed, as well as associations between these findings and pathological features of the tumors. Variations in maxSUV among institutions and the underestimations derived from small tumors, which are limitations of PET performed in multicenter studies, were adjusted using a phantom study. RESULTS: The maxSUV, BAC ratio, TDR, and GGO ratio (in that order) reflected the grade of tumor invasiveness and lymph node metastasis. The maxSUV and BAC ratio were found to be significant prognostic predictors derived from disease-free survival curves. Although the BAC ratio was found to be significantly associated with preoperative radiographic parameters, the maxSUV, GGO ratio, and TDR (all P < .0001), the degree of correlation with maxSUV (correlation coefficient [R(2)] = 0.1699) was much weaker than that reported with the GGO ratio (R(2) = 0.5860) or TDR (R(2) = 0.5082). CONCLUSIONS: Phantom studies can overcome the difficulties of multicenter studies using PET. A higher maxSUV appears to reflect aggressive malignant behavior in clinical T1N0M0 adenocarcinomas, independent of BAC components. Preoperative PET/CT assessment in addition to HRCT could be used to construct hypotheses for a future clinical study of strategies for the treatment of patients with small lung adenocarcinoma.
Authors:
Haruhiko Nakayama; Sakae Okumura; Hiromitsu Daisaki; Yasufumi Kato; Hirofumi Uehara; Shuji Adachi; Masahiro Yoshimura; Morihito Okada
Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Cancer     Volume:  116     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3170-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology*,  radionuclide imaging*
Aged
Disease-Free Survival
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Lung Neoplasms / pathology*,  radionuclide imaging*
Male
Middle Aged
Neoplasm Invasiveness
Phantoms, Imaging*
Positron-Emission Tomography / methods*
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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