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18F-fluorodeoxyglucose positron emission tomography is correlated with the pathological necrosis and decreased microvessel density in lung adenocarcinomas

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Abstract

Objective

We explored the relationship between preoperative 18F-FDG-PET parameters, tumor necrosis, and microvessel density (MVD) in patients with pulmonary adenocarcinomas.

Methods

A total of 164 patients, who underwent surgical resection for lung adenocarcinoma, were reviewed retrospectively. The maximum standardized uptake value (SUVmax), peak SUV corrected for lean body mass (SULpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) values were measured by preoperative 18F-FDG-PET. The extent of tumor necrosis was examined and CD31 expression was evaluated to count the MVD.

Results

The SUVmax, SULpeak, MTV, and TLG levels were significantly lower in patients exhibiting no necrosis compared to those with necrosis. When we divided the patients into two groups based on high vs. low PET parameter values, elevated SUVmax, SULpeak, MTV, and TLG values were significantly more associated with partial or diffuse necrosis than were lower values (p < 0.001). A negative correlation was evident between the MVD and SUVmax, MVD and SULpeak, MVD and MTV, and MVD and TLG. Tumor necrosis was correlated with a shorter overall survival (OS) (p = 0.007) and recur-free survival (RFS) (p < 0.001). However, multivariate analysis revealed that necrosis was not of prognostic significance. The SUVmax, MTV and TLG were associated with inferior OS or RFS rates in univariate analysis, however, not in multivariate analysis.

Conclusion

High-level FDG accumulation is correlated with tumor necrosis in lung adenocarcinoma.

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Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT (NRF-2017R1C1B5076342 for Young Wha Koh and NRF-2016R1C1B2011583 for Su Jin Lee) and by the New Faculty Research Fund of Ajou University School of Medicine to Young Wha Koh.

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Author notes

  1. Su Jin Lee and Seong Yong Park contributed equally to the paper as corresponding author.

Authors and Affiliations

  1. Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea

    Young Wha Koh

  2. Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 206 Worldcup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea

    Su Jin Lee

  3. Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Seong Yong Park

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  1. Young Wha Koh
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Correspondence to Su Jin Lee or Seong Yong Park.

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Koh, Y.W., Lee, S.J. & Park, S.Y. 18F-fluorodeoxyglucose positron emission tomography is correlated with the pathological necrosis and decreased microvessel density in lung adenocarcinomas. Ann Nucl Med 33, 93–102 (2019). https://doi.org/10.1007/s12149-018-1309-1

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  • DOI: https://doi.org/10.1007/s12149-018-1309-1

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