Jongtae Cha

Correlation Analysis and Prognostic Impact of 18F-FDG PET and Excision Repair Cross-Complementation Group 1 (ERCC-1) Expression in Non-Small Cell Lung Cancer

PurposeThe aim of this study was to determine the relationship between [18]-2-fluoro-2-deoxy-D-glucose (FDG) uptake and excision repair cross-complementation group 1 (ERCC-1) expression and to evaluate the prognostic effect of these two factors in resectable non-small cell lung cancer (NSCLC) patients.MethodsWe retrospectively reviewed 212 patients with resectable NSCLC who underwent FDG positron emission tomography/computed tomography (PET/CT) scan for cancer staging and ERCC-1 expression analysis between January 2008 to December 2011. All patients were then followed-up for survival analysis. Semiquantitative evaluation of ERCC-1 was performed with the H-scoring system and was correlated with maximum standardized uptake value (SUVmax) of NSCLC. Univariate and multivariate analyses were performed to evaluate for FDG uptake and ERCC-1 expression predicting overall survival.ResultsIn 212 patients (139 male, median age 68u2009±u20099.11), 112 patients had ERCC-positive tumors and 100 patients had ERCC-negative tumors. There was no significant difference in SUVmax between ERCC-1-positive tumors (8.02u2009±u20095.40) and ERCC-1-negative tumors (7.57u2009±u20096.56, pu2009=u20090.584). All patients were followed-up for a median of 40.5xa0months (95xa0% confidence interval [CI], 38.5–42.2xa0months). Univariate analysis and multivariate analysis for all patients showed that both ERCC-1 expression (hazard ratio [HR], 2.78; 95xa0% CI, 1.20–6.47) and FDG uptake (HR, 4.50; 95xa0% CI, 2.07–9.77) independently predicted overall survival.ConclusionsWe have found no statistical correlation between FDG uptake and ERCC-1 expression in NSCLC. However, both higher FDG uptake and positive ERCC-1 expression are independent predictive markers of prognosis, suggesting that both should be obtained during patient workup.

A hierarchical prognostic model for risk stratification in patients with early breast cancer according to 18F-fludeoxyglucose uptake and clinicopathological parameters

This study was to investigate a hierarchical prognostic model using clinicopathological factors and 18F‐fludeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) for recurrence‐free survival (RFS) in patients with early breast cancer who underwent surgery without neoadjuvant chemotherapy. A total of 524 patients with early breast cancer were included. The Cox proportional hazards model was used with clinicopathological variables and maximum standardized uptake value (SUVmax) on PET/CT. After classification and regression tree (CART) modeling, RFS curves were estimated using the Kaplan–Meier method and differences in each risk layer were assessed using the log‐rank test. During a median follow‐up of 46.2 months, 31 (5.9%) patients experienced recurrence. The CART model identified four risk layers: group 1 (SUVmax ≤6.75 and tumor size ≤2.0 cm); group 2 (SUVmax ≤6.75 and Luminal A [LumA] or TN tumor >2.0 cm); group 3 (SUVmax ≤6.75 and Luminal B [LumB] or human epidermal growth factor receptor 2 [HER2]‐enriched] tumor >2.0 cm); group 4 (SUVmax >6.75). Five‐year RFS was as follows: 95.9% (group 1), 98% (group 2), 82.8% (group 3), and 85.4% (group 4). Group 3 or group 4 showed worse prognosis than group 1 or group 2 (group 1 vs. group 3: P = 0.040; group 1 vs. group 4: P < 0.001; group 2 vs. group 3: P = 0.016; group 2 vs. group 4: P < 0.001). High SUVmax (>6.75) in primary breast cancer was an independent factor for poor RFS. In patients with low SUVmax, LumB or HER2‐enriched tumor >2 cm was also prognostic for poor RFS, similar to high SUVmax.

Evaluation of 18 F-FDG PET/CT Parameters for Detection of Lymph Node Metastasis in Cutaneous Melanoma

PurposeThe purpose of this study was to investigate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in the detection of regional lymph node (LN) metastasis in patients with cutaneous melanoma.MethodsWe evaluated patients with cutaneous melanoma who underwent FDG PET/CT for initial staging or recurrence evaluation. A total of 103 patients were enrolled, and 165 LNs were evaluated. LNs that were confirmed pathologically or by follow-up imaging were included in this study. PET parameters, including maximum standardized uptake value (SUVmax), total lesion glycolysis and tumour-to-liver ratio, were used to determine the presence of metastases, and the results were compared with CT-determined LN metastasis. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values of the FDG PET parameters.ResultsA total of 93 LNs were malignant, and 84 LNs were smaller than 10xa0mm. In all 165 LNs, an SUVmax of >2.51 showed a sensitivity of 73.1%, a specificity of 88.9%, and an accuracy of 80.0% in detecting metastatic LNs. CT showed a higher specificity (87.3%) and lower accuracy (65.5%). For non-enlarged regional LNs (<10xa0mm), an SUVmax cut-off value of 1.4 showed the highest negative predictive value (81.3%). For enlarged LNs (≥10xa0mm), an SUVmax cut-off value of 2.4 showed the highest sensitivity (90.7%) and accuracy (88.9%) in detecting metastatic LNs.ConclusionsIn patients with cutaneous melanoma, an SUVmax of >2.4 showed a high sensitivity (91%) and accuracy (89%) in detecting metastasis in LNs ≥1xa0cm, and LNs <1xa0cm with an SUVmax <1.4 were likely to be benign.

A Comparison Study of Esophageal Findings on (18)F-FDG PET/CT and Esophagogastroduodenoscopy

PurposeThe aim of this study was to compare the esophageal findings of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography–computed tomography (18F-FDG PET/CT) and esophagogastroduodenoscopy (EGD).MethodsWe retrospectively reviewed 18F-FDG PET/CT and EGD findings of 369 subjects who underwent medical examination between January 2014 and December 2014. The range and intensity of esophageal 18F-FDG uptake were visually analyzed. The maximum standardized uptake value (SUVmax) of the esophagus and around the esophagogastric (EG) junction was measured. EGD results were provided by the gastroenterologist. We compared the esophageal findings obtained using 18F-FDG PET/CT and EGD.ResultsThere were typical linear FDG uptakes in 18F-FDG PET/CT patients who underwent EGD the same day. In visual analysis of the range and intensity of the 18F-FDG uptake, the patients who underwent 18F-FDG PET/CT and EGD on the same day showed relatively diffuse and discernible 18F-FDG uptake in the esophagus. Reflux esophagitis was diagnosed in 59 subjects, and 27 of these were classified as higher than Los Angeles classification A. With an increasing degree of reflux esophagitis observed on EGD, the SUVmax in the esophagus and around the EG junction was also increased.ConclusionOur study showed that FDG uptake at the esophagus or the EG junction might be clinically significantly related to esophagitis. However, EGD performed before 18F-FDG PET/CT on the same day may affect the esophageal 18F-FDG uptake.