Elsevier

Journal of Thoracic Oncology

Volume 3, Issue 9, September 2008, Pages 971-978
Journal of Thoracic Oncology

Original Article
Relationship Between Non-small Cell Lung Cancer FDG Uptake at PET, Tumor Histology, and Ki-67 Proliferation Index

https://doi.org/10.1097/JTO.0b013e31818307a7Get rights and content
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Introduction

We compared primary non-small cell lung cancer (NSCLC) 18F-fluorodeoxyglucose (FDG) uptake at positron emission tomography (PET) to tumor histologic features and Ki-67 proliferation index. This large, prospectively-recruited patient cohort has previously been analyzed based on differences in FDG uptake across stage groups; the current analysis adds further dimensions to this characterization.

Materials and Methods

One hundred seventy-eight patients with potentially-resectable NSCLC were scanned with FDG PET before therapy. A partial volume correction algorithm was used to correct FDG uptake values for their dependence on tumor size. Primary tumor resection specimens, core biopsies, and biopsies of metastatic lymph nodes were used to assess each tumor's NSCLC histologic subtype, degree of differentiation, and Ki-67 proliferation index.

Results

Bronchioalveolar carcinomas were found to have lower FDG uptake at PET and lower Ki-67 scores than any other histologic subtype. Non-bronchioalveolar adenocarcinomas had lower FDG uptake and Ki-67 scores than squamous cell carcinomas or large cell undifferentiated carcinomas. Better differentiated NSCLCs had lower FDG uptake and Ki-67 scores than more poorly differentiated NSCLCs. There was a significant positive correlation between FDG uptake and Ki-67 scores. Partial volume correction increased the strength of this correlation, while also diminishing the strong positive correlation between FDG uptake and tumor size.

Conclusions

There are significant differences in NSCLC FDG uptake across histologic subtypes and differentiation groups. These differences parallel nearly identical differences in Ki-67 scores, implying that differences in NSCLC tumor cell proliferation may give rise to commensurate differences in tumor glucose metabolism.

Key Words

Positron emission tomography
Non-small cell lung cancer
histology
Ki-67

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Supported by NIH grants 1R01 CA115559, 1R01 CA107264, and 1R01 CA80907.