K. Higashi et al., FLUORINE-18-FDG PET IMAGING IS NEGATIVE IN BRONCHIOLOALVEOLAR LUNG-CARCINOMA, The Journal of nuclear medicine, 39(6), 1998, pp. 1016-1020
The goals of our study were to establish PET accuracy with F-18- fluor
odeoxyglucose (FDG) in finding localized formations of bronchioloalveo
lar lung carcinoma (BAC) and to investigate the correlation between FD
G uptake and the degree of cell differentiation in adenocarcinoma of t
he lung. Materials: Twenty-nine patients with 30 adenocarcinomas of th
e lung (7 bronchioloalveolar lung carcinomas, 9 well differentiated, 2
well-moderately differentiated, 11 moderately differentiated and 1 po
orly differentiated) were studied. All patients underwent thoracotomie
s within 4 wk after the FDG PET study. For qualitative analysis, the d
egree of FDG activity in the tumors was visually scored using a five-p
oint grading system: 0 = same to background activity, 1 = less than me
diastinal blood-pool activity, 2 = same to mediastinal blood-pool acti
vity, 3 = slightly greater than mediastinal blood-pool activity and 4
= substantially greater than mediastinal blood-pool activity. Foci of
activity with Grades 2-4 were considered tumors. For semiquantitative
analysis, standardized uptake values (SUV) were calculated. Results: I
n 7 BACs, 4 lesions (57%) showed negative results on FDG PET, while in
23 non-BACs, only 1 lesion (4%), which was a well-differentiated aden
ocarcinoma showed a negative result. BACs' mean visual score (1.43 +/-
1.27) was significantly lower than that of non-BACs (3.17 +/- 1.03) (
p = 0.001). The BACs' mean SUV (1.36 +/- 0.821) was significantly lowe
r than that of well-differentiated adenocarcinomas (2.92 +/- 1.28) (p
= 0.014); the mean SUV of well-differentiated adenocarcinomas was sign
ificantly lower than that of moderately differentiated adenocarcinomas
(4.63 +/- 1.86) (p = 0.031). No significant differences were apparent
in average size among these three histologic types. Conclusion: A cor
relation was observed between FDG uptake and the degree of cell differ
entiation in adenocarcinoma of the lung. FDG PET may show negative res
ults for BAC.