Impact of 18F-FDG PET/CT on the staging of patients with non-small cell lung cancer


  • Ngo Minh Xuan Department of Pediatric, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, Vietnam
  • Huynh Quang Huy Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh city, Vietnam



Computed tomography, Non-small cell lung cancer, Positron emission tomography, Standardized uptake value


Background: Non-small cell lung cancer (NSCLC) accounts for approximately 80% of new diagnoses of pulmonary carcinoma. This study investigated the correlation between 18 F-fluorodeoxyglucose uptake in computerized tomography integrated positron emission tomography and tumor size, lymph node metastasis, and distant metastasis in patients with NSCLC.

Methods: The records of 318 NSCLC patients (220 male, 98 females; mean age 60.94 years) were evaluated retrospectively.

Results: 278 cases were adenocarcinomas; 28 squamous cell carcinomas; and 12 large cell carcinoma. When the cases were categorized according to tumor size (group 1, ≤3 cm; group 2, >3 and ≤5 cm; group 3, >5 cm), the maximum standardized uptake value (SUVmax) was significantly lower in groups 1 and 2 compared with group 3 (p<0,001 for each). Considering all cases, tumor SUVmax was not correlated with age, gender or histopathological type. Lymph node metastases were seen in 250 cases: 80.2% of these were adenocarcinomas, 71.4% squamous cell carcinomas, and 58.3% large cell carcinomas. Neither lymph node involvement nor distant metastases were correlated with tumor SUVmax, although lymph node size was positively correlated with lymph node SUVmax (r=0.758; p<0.001).

Conclusions: SUVmax was significantly associated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases.



Vesselle H, Salskov A, Turcotte E, Wiens L, Schmidt R, Jordan CD, et al. Relationship between non-small cell lung cancer FDG uptake at PET, tumor histology, and Ki-67 proliferation index. J Thorac Oncol. 2008 Sep 1;3(9):971-8.

Cerfolio RJ, Ojha B, Bryant AS, Bass CS, Bartalucci AA, Mountz JM. The role of FDG-PET scan in staging patients with nonsmall cell carcinoma. Ann Thorac Surg. 2003 Sep 1;76(3):861-6.

Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non–small-cell lung cancer with integrated positron-emission tomography and computed tomography. New Engl J Medi. 2003 Jun 19;348(25):2500-7.

Pieterman RM, van Putten JW, Meuzelaar JJ, Mooyaart EL, Vaalburg W, Koëter GH, et al. Preoperative staging of non-small-cell lung cancer with positron-emission tomography. New Engl J Medi. 2000 Jul 27;343(4):254-61.

Toloza EM, Harpole L, McCrory DC. Noninvasive staging of non-small cell lung cancer: a review of the current evidence. Chest. 2003 Jan 1;123(1):137S-46S.

Crino L, Weder W, Van Meerbeeck J, Felip E. Early stage and locally advanced (non-metastatic) non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010 May;21(S 5):v103-15.

Ettinger DS, Akerley W, Bepler G, Blum MG, Chang A, Cheney RT, et al. Non-small cell lung cancer. J Nation Comprehens Cancer Netw. 2010 Jul 1;8(7):740-801.

Aquino SL, Halpern EF, Kuester LB, Fischman AJ. FDG-PET and CT features of non-small cell lung cancer based on tumor type. Int J Mol Medi. 2007 Mar 1;19(3):495-9.

Nambu A, Kato S, Sato Y, Okuwaki H, Nishikawa K, Saito A, et al. Relationship between maximum standardized uptake value (SUVmax) of lung cancer and lymph node metastasis on FDG-PET. Ann Nuclear Medi. 2009 May 1;23(3):269-75.

Higashi K, Ito K, Hiramatsu Y, Ishikawa T, Sakuma T, Matsunari I, et al. 18F-FDG uptake by primary tumor as a predictor of intratumoral lymphatic vessel invasion and lymph node involvement in non-small cell lung cancer: analysis of a multicenter study. J Nucl Medi. 2005 Feb 1;46(2):267-73.

Jeong HJ, Min JJ, Park JM, Chung JK, Kim BT, Jeong JM, et al. Determination of the prognostic value of [18F] fluorodeoxyglucose uptake by using positron emission tomography in patients with non-small cell lung cancer. Nucl Medi Comm. 2002 Sep 1;23(9):865-70.

Cerfolio RJ, Bryant AS, Ohja B, Bartolucci AA. The maximum standardized uptake values on positron emission tomography of a non-small cell lung cancer predict stage, recurrence, and survival. J Thor Cardiovasc Surg. 2005 Jul 1;130(1):151-9.




How to Cite

Xuan, N. M., & Huy, H. Q. (2020). Impact of 18F-FDG PET/CT on the staging of patients with non-small cell lung cancer. International Journal of Research in Medical Sciences, 8(6), 2023–2027.



Original Research Articles