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Updated: Apr 14, 2026
Utilizing 18F-FDG PET/CT Imaging and Quantitative Histology to Measure Dynamic Changes in the Glucose Metabolism in Mouse Models of Lung Cancer
Published on: July 21, 2018
Prognostic value of metabolic activity in noncancerous lung areas for stage I lung cancer
Takashi Yamamichi1, Yoshihisa Shimada1, Hideyuki Furumoto1
1Department of Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Background:
Tumor maximum standardized uptake value (tumor-SUVmax) on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is an established prognostic marker in lung cancer. However, metabolic activity of the background lung parenchyma has received little attention. Idiopathic pulmonary fibrosis (IPF) significantly worsens lung cancer prognosis; however, CT assessments have limitations in predicting outcomes. We investigated whether measuring SUVmax in noncancerous lung areas (NCA-SUVmax) could capture subclinical inflammatory activity and provide additional prognostic information.
Methods:
We retrospectively analyzed 616 patients with pathological stage I lung cancer, who had undergone surgical resection between 2012 and 2019. Both tumor-SUVmax and NCA-SUVmax were measured using preoperative FDG PET/CT. Receiver operating characteristic analysis revealed optimal NCA-SUVmax cutoff values. Survival outcomes between high (≥1.34) and low (<1.34) NCA-SUVmax groups were compared using Kaplan-Meier analysis and Cox regression models.
Results:
During a median follow-up of 60 months, 56 patients (9.1%) experienced recurrence and 89 (14.4%) died. Tumor-SUVmax and NCA-SUVmax showed weak correlations, independently predicting survival. Patients with high NCA-SUVmax (n = 162, 26.3%) had significantly worse 5-year disease-free (72.2% vs. 91.7%) and overall survival (77.2% vs. 93.1%). IPF prevalence was markedly higher in the high NCA-SUVmax group (29.6% vs. 2.9%). Multivariate analysis identified tumor-SUVmax and NCA-SUVmax as independent predictors (hazard ratios: 1.60 and 1.56). Patients with high NCA-SUVmax and IPF demonstrated particularly inferior outcomes (5-year survival: 52.0% disease-free, 52.4% overall).
Conclusions:
NCA-SUVmax provides independent prognostic information beyond conventional tumor-SUVmax for identifying high-risk patients with concurrent IPF. This parameter may improve risk stratification in patients with Stage I lung cancer.
