Association Analysis of Maximum Standardized Uptake Values Based on ¹⁸F-FDG PET/CT and EGFR Mutation Status in Lung...

(1) Background: To investigate the association between maximum standardized uptake value (SUV_max) based on ¹⁸F-FDG PET/CT and EGFR mutation status in lung adenocarcinoma. (2) Methods: A total of 366 patients were retrospectively collected and divided into the EGFR mutation group (n = 228) and EGFR wild-type group (n = 138) according to their EGFR mutation status. The two groups' general information and PET/CT imaging parameters were compared. A hierarchical binary logistic regression model was used to assess the interaction effect on the relationship between SUV_max and EGFR mutation in different subgroups. Univariate and multivariate logistic regression was used to analyze the association between SUV_max and EGFR mutation. After adjusting for confounding factors, a generalized additive model and smooth curve fitting were applied to address possible non-linearities. (3) Results: Smoking status significantly affected the relationship between SUV_max and EGFR mutation (p for interaction = 0.012), with an interaction effect. After adjusting for age, gender, nodule type, bronchial sign, and CEA grouping, in the smoking subgroup, curve fitting results showed that the relationship between SUV_max and EGFR mutation was approximately linear (df = 1.000, c² = 3.897, p = 0.048); with the increase in SUV_max, the probability of EGFR mutation gradually decreased, and the OR value was 0.952 (95%CI: 0.908-0.999; p = 0.045). (4) Conclusions: Smoking status can affect the relationship between SUV_max and EGFR mutation status in lung adenocarcinoma, especially in the positive smoking history subgroup. Fully understanding the effect of smoking status will help to improve the accuracy of SUV_max in predicting EGFR mutations.