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The impact of PET/CT and brain MRI for metastasis detection among patients with clinical T1-category lung cancer: Findings from a large-scale cohort study.

Purpose: [18F]-FDG PET/CT and brain MRI are common approaches to detect metastasis in patients of lung cancer. Current guidelines for the use of PET/CT and MRI in clinical T1-category lung cancer lack risk-based stratification and require optimization. This study stratified patients based on metasta...

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Published in:European Journal of Nuclear Medicine & Molecular Imaging Vol. 51; no. 11; pp. 3400 - 3417
Main Authors: Feng, Yi, Cheng, Bo, Zhan, Shuting, Liu, Haiping, Li, Jianfu, Chen, Peiling, Wang, Zixun, Huang, Xiaoyan, Fu, Xiuxia, Ye, Wenjun, Wang, Runchen, Wang, Qixia, Xiang, Yang, Wang, Huiting, Zhu, Feng, Zheng, Xin, Fu, Wenhai, Hu, Guodong, Chen, Zhuxing, He, Jianxing
Format: Journal Article
Published: Springer Nature Sep2024
Online Access:View this record in EBSCOhost
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      dt: Sep2024
      vid: 51
      iid: 11
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00259-024-06740-8
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        atl: The impact of PET/CT and brain MRI for metastasis detection among patients with clinical T1-category lung cancer: Findings from a large-scale cohort study.
      aug:
        au:
          Feng, Yi
          Cheng, Bo
          Zhan, Shuting
          Liu, Haiping
          Li, Jianfu
          Chen, Peiling
          Wang, Zixun
          Huang, Xiaoyan
          Fu, Xiuxia
          Ye, Wenjun
          Wang, Runchen
          Wang, Qixia
          Xiang, Yang
          Wang, Huiting
          Zhu, Feng
          Zheng, Xin
          Fu, Wenhai
          Hu, Guodong
          Chen, Zhuxing
          He, Jianxing
        affil: Department of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, 510120, Guangzhou, China
      sug:
      ab: Purpose: [18F]-FDG PET/CT and brain MRI are common approaches to detect metastasis in patients of lung cancer. Current guidelines for the use of PET/CT and MRI in clinical T1-category lung cancer lack risk-based stratification and require optimization. This study stratified patients based on metastatic risk in terms of the lesions' size and morphological characteristics. Methods: The detection rate of metastasis was measured in different sizes and morphological characteristics (solid and sub-solid) of tumors. To confirm the cut-off value for discriminating metastasis and overall survival (OS) prediction, the receiver operating characteristic (ROC) analysis was performed based on PET/CT metabolic parameters (SUVmax/SUVmean/SULpeak/MTV/TLG), followed by Kaplan–Meier analysis for survival in post-operation patients with and without PET/CT plus MRI. Results: 2,298 patients were included. No metastasis was observed in patients with solid nodules < 8.0 mm and sub-solid nodules < 10.0 mm. The cut-off of PET/CT metabolic parameters on discriminating metastasis were 1.09 (SUVmax), 0.26 (SUVmean), 0.31 (SULpeak), 0.55 (MTV), and 0.81 (TLG), respectively. Patients undergoing PET/CT plus MRI exhibited longer OS compared to those who did not receive it in solid nodules ≥ 8.0 mm & sub-solid nodules ≥ 10.0 mm (HR, 0.44; p < 0.001); in solid nodules ≥ 8.0 mm (HR, 0.12; p<0.001) and in sub-solid nodules ≥ 10.0 mm (HR; 0.61; p=0.075), respectively. Compared to patients with metabolic parameters lower than cut-off values, patients with higher metabolic parameters displayed shorter OS: SUVmax (HR, 12.94; p < 0.001), SUVmean (HR, 11.33; p <0.001), SULpeak (HR, 9.65; p < 0.001), MTV (HR, 9.16; p = 0.031), and TLG (HR, 12.06; p < 0.001). Conclusion: The necessity of PET/CT and MRI should be cautiously evaluated in patients with solid nodules < 8.0 mm and sub-solid nodules < 10.0 mm, however, these examinations remained essential and beneficial for patients with solid nodules ≥ 8.0 mm and sub-solid nodules ≥ 10.0 mm.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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