Predictive Value of 18F-FDG PET/CT for Spread Through Air Space Status in Stage IA Lung Adenocarcinoma
10.3969/j.issn.1005-5185.2025.11.007
- VernacularTitle:18F-FDG PET/CT对IA期肺腺癌气腔播散状态的预测价值
- Author:
Zujiang XIONG
1
;
Xuemei LIU
;
Jiong CAI
Author Information
1. 重庆市第五人民医院放射科,重庆 401336
- Publication Type:Journal Article
- Keywords:
Adenocarcinoma of lung;
Positron-emission tomography;
Tomography,X-ray computed;
Spread through air space;
Fluorodeoxyglucose F18;
Nomogram;
Risk factors;
Forecasting
- From:
Chinese Journal of Medical Imaging
2025;33(11):1180-1185
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To develop and validate a nomogram based on 18F-FDG PET/CT for predicting spread through air space(STAS)in stage IA lung adenocarcinoma(LUAD),providing imaging support for surgical decision-making.Materials and Methods This retrospective study analyzed 155 patients with pathologically confirmed stage IA LUAD from the Fifth People's Hospital of Chongqing,Affiliated Hospital of Zunyi Medical University and Cavalier Hospital(December 2019 to December 2023).Patients were stratified into STAS-positive and STAS-negative groups based on postoperative histopathological evaluation.Univariate and multivariate binary Logistic regression analyses identified risk factors for STAS from clinical characteristics,PET/CT semantic features,and metabolic parameters.A nomogram predicting preoperative STAS status was developed and internally validated using bootstrap resampling.Model performance was assessed in training and internal validation sets using receiver operating characteristic analysis,calibration curves and decision curve analysis.Results Among 155 stage IA LUAD patients,20(12.9%)were STAS-positive.Multivariate analysis identified tumor mean diameter(OR=0.618,P=0.024),solid component proportion(OR=2.678,P=0.033),and maximum standardized uptake value(OR=3.437,P=0.028)as independent STAS predictors.The nomogram demonstrated excellent discrimination,with areas under the curve of 0.912(95%CI 0.855-0.942)and 0.843(95%CI 0.805-0.923)in training and validation sets,respectively.Hosmer-Lemeshow goodness-of-fit test indicated satisfactory calibration(χ2=5.591,P=0.693).Decision curve analysis showed substantial net clinical benefit across threshold probabilities of 5%-91%.Conclusion The nomogram incorporating tumor diameter,solid component proportion,and maximum standardized uptake value from 18F-FDG PET/CT effectively predicts STAS status in stage IA LUAD,demonstrating high preoperative predictive performance.
