Department of Thoracic Oncology, Kanagawa Cancer Center Hospital, Japan.
Eur J Radiol. 2013 Nov;82(11):e721-5. doi: 10.1016/j.ejrad.2013.07.028. Epub 2013 Aug 12.
The prognostic value of maximum standardized uptake value (maxSUV) on (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is known for localized pulmonary adenocarcinoma, which is most commonly non-mucinous adenocarcinoma. We examined the validity of thin-section computed tomography (TS-CT) and FDG-PET findings in mucinous adenocarcinoma.
TS-CT and FDG-PET were performed on 25 patients with mucinous lung adenocarcinoma that was subsequently resected between January 2009 and March 2013. Based on the percentage reduction of maximum tumor diameter on the mediastinal window image compared with the diameter on the lung window image on TS-CT, tumors were classified as air-type (≥50%) or solid-type (<50%). All resected specimens were pathologically diagnosed according to the International Association for the Study of Lung Cancer (IASLC) classification, and the diameter of the pathological invasive area was assessed.
Most mucinous adenocarcinomas were located in the lower lobe. All except two were classified as solid-type tumor on TS-CT. Multiple regression analysis revealed the correlation of maxSUV with pathological tumor size and diameter of pathological invasive area; these two parameters showed no significant correlation with each other (r=0.354, p=0.083). maxSUV was significantly lower for tumors with invasive area ≤5 mm than for tumors with invasive area >5mm (1.62 vs. 3.77, p=0.01), but no statistically significant difference was found in terms of other pathological invasive findings such as the presence of lymphatic or vascular invasion, pleural involvement, or predominant histological subtype.
Most mucinous adenocarcinomas had appearances of solid-type tumor on TS-CT. maxSUV on FDG-PET indicates the pathological invasive area in mucinous adenocarcinoma as well as non-mucinous adenocarcinoma.
（18）F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）的最大标准化摄取值（maxSUV）对局部肺腺癌的预后价值是已知的，肺腺癌最常见的是非黏液性腺癌。我们检查了黏液性腺癌的薄层计算机断层扫描（TS-CT）和 FDG-PET 结果的有效性。
对 25 例于 2009 年 1 月至 2013 年 3 月间接受手术切除的黏液性肺腺癌患者进行了 TS-CT 和 FDG-PET 检查。基于纵隔窗图像上最大肿瘤直径与 TS-CT 上肺窗图像上直径的百分比降低，肿瘤分为气型（≥50%）或实体型（<50%）。所有切除标本均根据国际肺癌研究协会（IASLC）分类进行病理诊断，并评估病理侵袭区域的直径。
大多数黏液性腺癌位于下叶。除了两个之外，所有的肿瘤在 TS-CT 上均被分类为实体型肿瘤。多元回归分析显示 maxSUV 与病理肿瘤大小和病理侵袭区域直径相关；这两个参数彼此之间没有显著相关性（r=0.354，p=0.083）。侵袭区域≤5mm 的肿瘤的 maxSUV 显著低于侵袭区域>5mm 的肿瘤（1.62 与 3.77，p=0.01），但在其他病理侵袭发现方面，如存在淋巴管或血管侵犯、胸膜累及或主要组织学亚型，没有统计学差异。
大多数黏液性腺癌在 TS-CT 上具有实体型肿瘤的外观。FDG-PET 上的 maxSUV 可指示黏液性腺癌和非黏液性腺癌的病理侵袭区域。
