Prediction of Lymph Node Metastasis Using Semiquantitative Evaluation of PET for Lung Adenocarcinoma

This study aimed to investigate the efficacy of the Deauville criteria, 5-point semiquantitative scale criteria to assess the maximum standardized uptake value of [18F]-fluoro-2-deoxy-d-glucose (FDG) on positron emission tomography (PET)-computed tomography (CT), in predicting lymph node metastasis and other pathological invasive characteristics of early-stage lung adenocarcinoma.

In this retrospective study including 453 patients undergoing lobectomy or segmentectomy with lymph node dissection for clinical T1 or Tis N0 adenocarcinoma between April 2011 and March 2019, the FDG-PET/CT scans were evaluated using Deauville criteria to analyze the relationship of the Deauville score with the clinicopathological characteristics and prognosis.

The lymph node metastases were present in 0 (0%), 2 (1.1%), 6 (9.5%), 6 (15.8%), and 13 (15.7%) patients with Deauville scores of 1, 2, 3, 4, and 5, respectively. The pathological invasive characteristics (lymphatic, vascular, or visceral pleural invasion) were detected in 2 (2.4%), 17 (9.9%), 18 (28.6%), 23 (60.5%), and 54 (65.1%) patients with a Deauville score of 1, 2, 3, 4, and 5, respectively. The 3-year recurrence-free survival was longer in patients with a Deauville score of 1 to 2 (97.2%) than those with a Deauville score of 3 (86.2%; P < .001) or 4 to 5 (80.7%; P < .001).

The 5-point scale evaluation of the maximum standardized uptake value on FDG-PET/CT using the Deauville score was useful in predicting not only lymph node metastasis but also other malignant features of early-stage lung adenocarcinoma.