Author of

• 16637

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  P1.03 - Poster Session with Presenters Present (ID 455)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16664

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    P1.03-027 - Clinical and Histological Features Associated with SUV in FDG-PET-CT in Patients with Adenocarcinoma of the Lung (ID 4783)

    14:30 - 14:30  |  Author(s): J. Stump
    • Abstract

    Background:
    FDG-PET-CT is increasingly used for staging and treatment monitoring in NSCLC. The prognostic and possibly predictive value of the standardized-uptake-value (SUV), and the clinical, molecular and pathological features contributing to SUV levels have not been well described.
    
    Methods:
    We retrospectively reviewed the records of patients staged with FDG-PET-CT and correlated SUV values before and during treatment with clinical and pathological features of the tumour including CRP as a marker of systemic inflammation, adenocarcinoma subtype (solid, lepidic etc.), and Ki67, as a marker of tumour proliferation.
    
    Results:
    190 patients with adenocarcinoma of the lung were identified. 110 had FDG-PET-CT staging and were included in this analysis. Tumour subtypes were as follows: 50.0% solid, 16.4% acinar, 9.1% papillary, 7.3% lepidic, 1.8% micropapillary, 15.4% other. 70 patients received systemic treatment and 40 were treated surgically. The mean primary-tumour-SUV for all patients was 11.1 (for patients treated medically, 13.5, and for those treated surgically, 8.6). Ki67 expression in the tumour was lowest in the group with SUV < 10 (38.6%) and highest in the group with SUV > 20 (56.0). The group with SUV 11-19 had a moderate Ki67 expression (47.9%). In patients with surgical tumour samples there was a trend towards higher SUV in patients with tumours showing 30% or more solid growth pattern (mean SUV 11.4) and lower SUV in patients with any lepidic growth (mean SUV 4.0) (p=0.002). Systemic markers of inflammation were significantly higher in patients whose tumours had SUV>10 (mean CRP, 2.3 mg/dl; mean leukocytes, 9.7 G/L) than in patients with low-SUV tumours (<5) (mean CRP, 0.4 mg/dl, p=0.0186; mean leukocytes, 7.2 G/L, p=0.014).
    
    Conclusion:
    Multiple factors appear to be associated with higher or lower SUV values, including adenocarcinoma subtype, proliferation index of the tumour and systemic inflammation. These factors should be taken into account when interpreting FDG-PET-CT SUV values in clinical practice. The correlation of FDG-PET-CT SUV values with inflamed tumour phenotypes, and the possible predictive value of SUV for response to immune therapies, should be further investigated.