Prognostic role of positron emission tomography and computed tomography parameters in stage i lung adenocarcinoma

Angelo Carretta, Alessandro Bandiera, Piergiorgio Muriana, Stefano Viscardi, Paola Ciriaco, Ana Maria Samanes Gajate, Gianluigi Arrigoni, Chiara Lazzari, Vanesa Gregorc, Giampiero Negri

Research output: Contribution to journalArticlepeer-review

Abstract

According to the current pathological classification, lung adenocarcinoma includes histological subtypes with significantly different prognoses, which may require specific surgical approaches. The aim of the study was to assess the role of CT and PET parameters in stratifying patients with stage I adenocarcinoma according to prognosis. Fifty-eight patients with pathological stage I lung adenocarcinoma who underwent surgical treatment were retrospectively reviewed. Adenocarcinoma in situ and minimally-invasive adenocarcinoma were grouped as non-invasive adenocarcinoma. Other histotypes were referred as invasive adenocarcinoma. CT scan assessed parameters were: ground glass opacity (GGO) ratio, tumour disappearance rate (TDR) and consolidation diameter. The prognostic role of the following PET parameters was also assessed: standardized uptake value (SUV) max, SUVindex (SUVmax to liver SUVratio), metabolic tumour volume (MTV), total lesion glycolysis (TLG). Seven patients had a non-invasive adenocarcinoma and 51 an invasive adenocarcinoma. Five-year disease-free survival (DFS) and cancer-specific survival (CSS) for non-invasive and invasive adenocarcinoma were 100% and 100%, 70% and 91%, respectively. Univariate analysis showed a significant difference in SUVmax, SUVindex, GGO ratio and TDR ratio values between non-invasive and invasive adenocarcinoma groups. Optimal SUVmax, SUVindex, GGO ratio and TDR cut-off ratios to predict invasive tumours were 2.6, 0.9, 40% and 56%, respectively. TLG, SUVmax, SUVindex significantly correlated with cancer specific survival. CT and PET scan parameters may differentiate between non-invasive and invasive stage I adenocarcinomas. If these data are confirmed in larger series, surgical strategy may be selected on the basis of preoperative imaging.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalRadiology and Oncology
Volume54
Issue number3
DOIs
Publication statusPublished - May 28 2020

Keywords

  • adenocarcinoma
  • computed tomography
  • lung
  • PET
  • surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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