Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival.
10.3348/kjr.2013.14.2.375
- Author:
Youkyung LEE
1
;
Hyun Ju LEE
;
Young Tae KIM
;
Chang Hyun KANG
;
Jin Mo GOO
;
Chang Min PARK
;
Jin Chul PAENG
;
Doo Hyun CHUNG
;
Yoon Kyung JEON
Author Information
1. Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea. rosaceci@radiol.snu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
EGFR;
EGFR protein;
CT;
FDG-PET;
Non-small cell lung cancer
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Carcinoma, Non-Small-Cell Lung/metabolism/mortality/*radiography/*radionuclide imaging;
Chi-Square Distribution;
Female;
Fluorodeoxyglucose F18/therapeutic use;
Humans;
Lung Neoplasms/metabolism/mortality/*radiography/*radionuclide imaging;
Male;
Middle Aged;
Neoplasm Staging;
Positron-Emission Tomography/*methods;
Proportional Hazards Models;
ROC Curve;
Radiopharmaceuticals/diagnostic use;
Receptor, Epidermal Growth Factor/*metabolism;
Statistics, Nonparametric;
Survival Rate;
Tomography, X-Ray Computed/*methods
- From:Korean Journal of Radiology
2013;14(2):375-383
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To identify CT and FDG-PET features associated with epidermal growth factor receptor (EGFR) protein overexpression, and to evaluate whether imaging features and EGFR-overexpression can help predict clinical outcome. MATERIALS AND METHODS: In 214 patients (M : F = 129 : 85; mean age, 63.2) who underwent curative resection of stage I non-small cell lung cancer, EGFR protein expression status was determined through immunohistochemical analysis. Imaging characteristics on CT and FDG-PET was assessed in relation to EGFR-overexpression. Imaging features and EGFR-overexpression were also evaluated for clinical outcome by using the Cox proportional hazards model. RESULTS: EGFR-overexpression was found in 51 patients (23.8%). It was significantly more frequent in tumors with an SUVmax > 5.0 (p < 0.0001), diameter > 2.43 cm (p < 0.0001), and with ground glass opacity < or = 50% (p = 0.0073). SUVmax > 5.0 (OR, 3.113; 95% CI, 1.375-7.049; p = 0.006) and diameter > 2.43 cm (OR, 2.799; 95% CI, 1.285-6.095; p = 0.010) were independent predictors of EGFR overexpression. Multivariate analysis showed that SUVmax > 4.0 (hazard ratio, 10.660; 95% CI, 1.370-82.966; p = 0.024), and the presence of cavitation within a tumor (hazard ratio, 3.122; 95% CI, 1.143-8.532; p = 0.026) were factors associated with poor prognosis. CONCLUSION: EGFR-overexpression is associated with high SUVmax, large tumor diameter, and small GGO proportion. CT and FDG-PET findings, which are closely related to EGFR overexpression, can be valuable in the prediction of clinical outcome.
