Predictive value of 18F-FDG PET/CT metabolic parameters for lymph node metastasis of non-small cell lung cancer.

Background: Lymph node metastasis is closely associated with the prognosis of patients with non-small cell lung cancer (NSCLC). This study aimed to evaluate the role of preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters in mediastinal lymph node metastasis in NSCLC.

Methods: One hundred patients with NSCLC who underwent surgery, systematic lymph node dissection, who had undergone 18FFDG PET/CT for initial staging were divided into two groups: lymph node metastasis and non-metastasis. The maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), SUV in the liver (SURliver), mediastinal blood pool (SURblood), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were detected in both groups. Receiver operating characteristic (ROC) curves were used to evaluate the parameters for predicting the diagnostic efficacy.

Results: The SUVmax, SUVmean, SURblood, SURliver, MTV, and TLG were higher in the group with lymph node metastasis than in the group without lymph node metastasis. The ROC analysis showed that 18F-FDG PET/CT demonstrated acceptable predictive ability with AUC of 0.964 (95% CI, 0.930-0.998).

Conclusions: The relative 18F-FDG PET/CT primary uptake and substitution parameters showed acceptable predictive efficacy for mediastinal lymph node metastasis in patients with NSCLC. Additional, SURblood has potential for clinical application.