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Relationship of EGFR Mutation to Glucose Metabolic Activity and Asphericity of Metabolic Tumor Volume in Lung Adenocarcinoma

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Abstract

Purpose

EGFR-mutation (EGFR-mt) is a major oncogenic driver mutation in lung adenocarcinoma (ADC) and is more often observed in Asian population. In lung ADC, some radiomics parameters of FDG PET have been reported to be associated with EGFR-mt. Here, the associations between EGFR-mt and PET parameters, particularly asphericity (ASP), were evaluated in Asian population.

Methods

Lung ADC patients who underwent curative surgical resection as the first treatment were retrospectively enrolled. EGFR mutation was defined as exon 19 deletion and exon 21 point mutation and was evaluated using surgical specimens. On FDG PET, image parameters of maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and ASP were obtained. The parameters were compared between EGFR-mt and wild type (EGFR-wt) groups, and the relationships between these PET parameters and EGFR-mt were evaluated.

Results

A total of 64 patients (median age 66 years, M:F = 34:30) were included in the analysis, and 29 (45%) patients showed EGFR-mt. In EGFR-mt group, all the image parameters of SUVmax, MTV, TLG, and ASP were significantly lower than in EGFR-wt group (all adjusted P < 0.050). In univariable logistic regression, SUVmax (P = 0.003) and ASP (P = 0.010) were significant determinants for EGFR-mt, whereas MTV was not (P = 0.690). Multivariate analysis revealed that SUVmax and ASP are independent determinants for EGFR-mt, regardless of inclusion of MTV in the analysis (P < 0.05).

Conclusion

In Asian NSCLC/ADC patients, SUVmax, MTV, and ASP on FDG PET are significantly related to EGFR mutation status. Particularly, low SUVmax and ASP are independent determinants for EGFR-mt.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Wonseok Whi, Seunggyun Ha, Sungwoo Bae, Hongyoon Choi, Jin Chul Paeng, Gi Jeong Cheon, Keon Wook Kang & Dong Soo Lee

  2. Molecular Medicine and Biopharmaceutical Science, Graduate School of Convergence Science and Technology Seoul National University, Seoul, South Korea

    Wonseok Whi & Sungwoo Bae

  3. Division of Nuclear Medicine Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea

    Seunggyun Ha

  4. Cancer Research Institute, Seoul National University, Seoul, South Korea

    Gi Jeong Cheon & Keon Wook Kang

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Correspondence to Seunggyun Ha or Jin Chul Paeng.

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Conflict of Interest

Wonseok Whi, Seunggyun Ha, Sungwoo Bae, Hongyoon Choi, Jin Chul Paeng, Gi Jeong Cheon, Keon Wook Kang, and Dong Soo Lee declare that there is no conflict of interest. There is no source of funding.

Ethical Statement

All procedures followed were performed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2013. The study design of the retrospective analysis and exemption of informed consent were approved by the Institutional Review Board of the Seoul National University Hospital (2001–146-1097). This manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.

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Whi, W., Ha, S., Bae, S. et al. Relationship of EGFR Mutation to Glucose Metabolic Activity and Asphericity of Metabolic Tumor Volume in Lung Adenocarcinoma. Nucl Med Mol Imaging 54, 175–182 (2020). https://doi.org/10.1007/s13139-020-00646-7

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  • DOI: https://doi.org/10.1007/s13139-020-00646-7

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