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A clinical study coordinated by Hospital General Universitario Santa Lucía with the collaboration of the departments of nuclear medicine from Hospital Universitario de Toledo and Hospital Universitario de Ciudad Real, and the department of surgery of Hospital General Universitario de Albacete has found metabolic variables predicting recurrence in non-small-cell lung cancer after curative surgery.
The study aimed to analyze the clinicopathologic and metabolic parameters derived from staging 18F-FDG PET/CT that can predict recurrence patterns in non-small-cell lung cancer (NSCLC) after curative surgery.
Stage I-III NSCLC patients with a baseline 18F-FDG PET/CT scan were included and relapse patterns analyzed based on location, lesion and organ-specific recurrence. Standardized uptake value (SUV)-based metrics, heterogeneity parameters, and morphological features were obtained and the relation of relapse patterns with clinicopathologic and metabolic parameters were analyzed.
In the 173-patient cohort, adenocarcinoma histology was identified as an independent variable for distant recurrence. Patient age, number of metastatic mediastinal lymph nodes at
staging (nN), sphericity, normalized SUVpeak to centroid distance (nSCD), entropy, low gray-level run emphasis, and high gray-level run emphasis were independent variables for polymetastatic disease. Certain variables were correlated with organ-specific recurrence. Bone recurrence was related to nN and
SUVmean. Brain recurrence was related to adenocarcinoma histology. Lung recurrence was associated with coefficient of variation and nSPD.
Thus, the metabolic profile of lung primary tumors obtained from 18F-FDG PET/CT seems to be predictive of recurrence patterns that are closely linked to the overall survival of NSCLC patients. These findings could help in the development of personalized follow-up strategies based on an individual's recurrence
pattern.
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