このエントリーをはてなブックマークに追加
ID 20584
file
creator
Tauchi, Shunsuke
Iwanaga, Koichiro
Mimura, Takeshi
Kitamura, Yoshitaka
Watanabe, Hirokazu
Adachi, Shuji
Sakuma, Toshiko
Ohbayashi, Chiho
subject
bronchioloalveolar carcinoma
sublobar resection
adenocarcinoma
FDG-PET/CT
NDC
Medical sciences
abstract
Objective: The aggressiveness of small adenocarcinomas has not been fully evaluated using integrated positron emission tomography/computed tomography (PET/CT). We investigated malignant aggressiveness according to PET/CT, high-resolution computed tomography (HR-CT) findings and the proportions of pathologically defined bronchioloalveolar carcinomas (BACs) in cT1N0M0 lung adenocarcinoma. Methods: Sixty consecutive patients with cT1N0M0 lung adenocarcinomas of 3 cm or less in diameter, underwent fluorodeoxyglucose (FDG)-PET/CT and HR-CT followed by complete tumor resection. Correlations between the proportion of BAC and maximum standardized uptake value (SUV) on PET/CT, ground-glass opacity (GGO) and tumor shadow disappearance rate (TDR) were investigated and the findings were compared with clinicopathological features. Results: Lymphatic and vascular invasion occurred in 18 (30%) and 13 (22%) patients, respectively, whereas hilar or mediastinal lymph nodes were involved in 8 patients (13%). Maximum SUV generally seemed the most valuable predictor of lymphatic invasion, vascular invasion and nodal metastasis, compared with GGO, TDR and BAC ratios. Although the association was significant between the BAC ratio versus maximum SUV, GGO ratio and TDR (all p<0.0001), maximum SUV (R2 = 0.245) was less correlated with the BAC ratio than the GGO ratio (R2 = 0.554) and TDR (R2 = 0.671). Conclusions: The malignant behavior of small adenocarcinomas with a lower maximum SUV and a greater proportion of GGO, TDR and BAC was less aggressive. Maximum SUV was a more powerful clinical predictor of biological tumor performance, independently of pathological BAC proportion. Preoperative assessment of maximum SUV on PET/CT in addition to the GGO ratio and TDR on HR-CT might be useful to guide treatment strategies for small adenocarcinomas.
journal title
The Journal of Thoracic and Cardiovascular Surgery
volume
Volume 133
issue
Issue 6
start page
1448
end page
1454
date of issued
2007
publisher
Mosby-Elsevier
issn
0022-5223
ncid
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
Copyright (c) 2007 The American Association for Thoracic Surgery.
department
Research Institute for Radiation Biology and Medicine