Background: A fundamental property of malignant tumors is increased glucose metabolism, which can be estimated by imaging the glucose analog fluorodeoxyglucose (FDG). The aim of this study was to determine whether FDG uptake in lung carcinoma, as measured on positron emission tomography (PET) imaging in patients with newly diagnosed bronchogenic carcinoma, has prognostic significance.
Methods: A retrospective review of all patients with a new diagnosis of nonsmall cell lung carcinoma and FDG-PET imaging was performed. Stage at presentation, cell type, tumor size, and survival data were recorded. For each patient, a standardized uptake ratio (SUR) was calculated for the primary lesion on PET and was correlated with clinical information to determine prognostic significance.
Results: One hundred fifty-five patients, with a mean age of 56 years, were enrolled. One hundred eighteen patients (76%) had lesions with SUR values <10 and had a median survival of 24.6 months (95% confidence interval [CI]: 20.9-41.1). Thirty-seven patients (24%) had tumor lesions with SUR values >10 and had a median survival of 11.4 months (95% CI: 9.3-19.4). An SUR >10 correlated with poorer survival (P = 0.0049). Patients with primary lesions >3 cm and an SUR > 10 had the worst prognosis, with a median survival of 5.7 months (95% CI: 4.0-13.1). Multivariate analysis demonstrated than an SUR > 10 provided prognostic information independent of the clinical stage and lesion size.
Conclusions: On PET studies of patients with lung carcinoma, FDG uptake within the primary lesion correlates with survival.