18F-FDG PET/CT in Predicting WHO(2021)Histological Grades of Invasive Pulmonary Adenocarcinoma
10.3969/j.issn.1005-5185.2025.02.012
- VernacularTitle:18F-FDG PET/CT预测浸润性肺腺癌WHO(2021)组织学分级
- Author:
Qin SHI
1
;
Yifan ZHANG
1
;
Yi YANG
1
;
Bo PAN
1
;
Ming NI
1
Author Information
1. 中国科学技术大学附属第一医院(安徽省立医院)核医学科,安徽 合肥 230001
- Publication Type:Journal Article
- Keywords:
Lung neoplasms;
Adenocarcinoma of Lung;
International classification of diseases;
Tomography,X-ray computed;
Positron-emission tomography;
Fluorodeoxyglucose F18;
Pathology,surgical;
Forecasting
- From:
Chinese Journal of Medical Imaging
2025;33(2):171-176,178
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the role of 18F-FDG PET/CT in predicting histological grade of invasive pulmonary adenocarcinoma in the WHO(2021)classification.Materials and Methods The Clinical,pathological and PET/CT data of 255 patients with invasive pulmonary adenocarcinoma confirmed by surgical pathology were retrospectively analyzed from May 2015 to August 2023.Tertiary tumor grading was performed according to the WHO(2021)classification.The clinicopathologic features,maximum standardized uptake value(SUVmax),maximum standardized uptake,total lesion glycolysis and CT imaging findings were compared among the three tumor grades.Logistic regression analysis was used to screen the independent predictors for grade 3 tumors,and performance evaluation was performed using receiver operating characteristic curve.Results Higher tumor grade was associated with male sex(χ2=11.803,P=0.003),smoking history(χ2=7.702,P=0.021),maximum tumor diameter(H=20.548,P=0.002),lymph node metastasis(P<0.001),vascular cancer thrombus(χ2=33.270,P<0.001),pleural invasion(χ2=15.116,P=0.001)and airway spread(χ2=17.867,P<0.001).SUVmax(H=71.488,P<0.001),total lesion glycolysis(H=30.658,P<0.001)and the proportion of pure solid tumors on CT image(χ2=28.872,P<0.001)all increased significantly with higher tumor grade.A higher SUVmax(OR=1.234,95%CI 1.141-1.334,P<0.001)and pure solid appearance(OR=2.205,95%CI 1.166-4.171,P=0.015)were independent predictors of grade 3 tumors.The area under the receiver operating characteristic curve for SUVmax,CT solid appearance and the combination for predicting grade 3 tumors was 0.793,0.641 and 0.804,respectively,with the SUVmax cut-off of 6.08.Conclusion SUVmax and CT solid appearance are independent predictive factors for grade 3 invasive pulmonary adenocarcinoma.Preoperative 18F-FDG PET/CT can assist in evaluating the grading of invasive pulmonary adenocarcinoma,which improves treatment decision-making.
