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Influx rate constant of 18F-FDG increases in metastatic lymph nodes of non-small cell lung cancer patients

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Abstract

Purpose

Primary tumor (PT) and metastatic lymph node (MLN) status have a great influence on diagnosis and treatment of lung cancer. Our main purpose was to investigate the imaging characteristics of PT or MLN by applying the 18F-FDG PET dynamic modeling approach for non-small cell lung cancer (NSCLC).

Methods

Dynamic 18F-FDG PET scans were performed for 76 lung cancer patients, and 62 NSCLC cases were finally included in this study: 37 with newly diagnosed early and locally advanced lung cancer without distant metastases (group M0) and 25 metastatic lung cancer (group M1). Patlak graphic analysis (Ki calculation) based on the dynamic modeling and SUV analysis from conventional static data were performed.

Results

For PT, both KiPT (0.050 ± 0.005 vs 0.026 ± 0.004 min−1, p < 0.001) and SUVPT (8.41 ± 0.64 vs 5.23 ± 0.73, p < 0.01) showed significant higher values in group M1 than M0. For MLN, KiMLN showed significant higher values in M1 than M0 (0.033 ± 0.005 vs 0.016 ± 0.003 min−1, p < 0.01), while no significant differences were found for SUVMLN between M0 and M1 (4.22 ± 0.49 vs 5.57 ± 0.59, p > 0.05). Both SUV PT and KiPT showed significant high values in squamous cell carcinoma than adenocarcinoma, but neither SUVPT nor KiPT showed significant differences between EGFR mutants versus wild types. The overall Spearman analysis for SUV and Ki from different groups showed variable correlation (r = 0.46–0.94).

Conclusion

The dynamic modeling for MLN (KiMLN) showed more sensitive than the static analysis (SUV) to detect metastatic lymph nodes in NSCLC, although both methods were sensitive for PT. This methodology of non-invasive imaging may become an important tool to evaluate MLN and PT status for patients who cannot undergo histological examination.

Clinical trial registration

The clinical trial registration number is NCT03679936 (http://www.clinicaltrials.gov/).

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was funded by the National Key R&D Program of China (2018YFC0910601), the National Natural Science Foundation of China (No.81871382), and Starting Fund from Sun Yat-sen University Fifth Affiliated Hospital.

Author information

Author notes

  1. Min Yang, Zhong Lin and Zeqing Xu contributed equally to this work.

Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Min Yang, Dan Li & Hongjun Jin

  2. Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Min Yang, Dan Li & Hongjun Jin

  3. Center of Oncology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Zhong Lin, Weize Lv & Shuai Yang

  4. Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Zeqing Xu

  5. Department of Pathology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Ye Liu

  6. The First Medical Center of PLA General Hospital, Beijing, 100853, China

    Ying Cao

  7. Department of Cardiothoracic Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, 519000, Guangdong Province, China

    Qingdong Cao

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  1. Min Yang
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Contributions

All authors contributed to the study conception and design; the final analysis and writing of the manuscript.

Corresponding authors

Correspondence to Qingdong Cao or Hongjun Jin.

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Yang, M., Lin, Z., Xu, Z. et al. Influx rate constant of 18F-FDG increases in metastatic lymph nodes of non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging 47, 1198–1208 (2020). https://doi.org/10.1007/s00259-020-04682-5

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