Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival

  • Lee, Youkyung (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Hyun-Ju (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Young Tae (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Cancer Research Institute, Xenotransplantation Research Center, Clinical Research Center, Seoul National University College of Medicine) ;
  • Kang, Chang Hyun (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Cancer Research Institute, Xenotransplantation Research Center, Clinical Research Center, Seoul National University College of Medicine) ;
  • Goo, Jin Mo (Department of Radiology, Seoul National University Hospital) ;
  • Park, Chang Min (Department of Radiology, Seoul National University Hospital) ;
  • Paeng, Jin Chul (Department of Nuclear Medicine, Seoul National University Hospital) ;
  • Chung, Doo Hyun (Department of Pathology, Seoul National University Hospital) ;
  • Jeon, Yoon Kyung (Department of Pathology, Seoul National University Hospital)
  • Published : 2013.04.01
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Abstract

Objective: To identify CT and FDG-PET features associated with epidermal growth factor receptor (EGFR) protein overexpression, and to evaluate whether imaging features and EGFR-overexpression can help predict clinical outcome. Materials and Methods: In 214 patients (M : F = 129 : 85; mean age, 63.2) who underwent curative resection of stage I non-small cell lung cancer, EGFR protein expression status was determined through immunohistochemical analysis. Imaging characteristics on CT and FDG-PET was assessed in relation to EGFR-overexpression. Imaging features and EGFR-overexpression were also evaluated for clinical outcome by using the Cox proportional hazards model. Results: EGFR-overexpression was found in 51 patients (23.8%). It was significantly more frequent in tumors with an $SUV_{max}$ > 5.0 (p < 0.0001), diameter > 2.43 cm (p < 0.0001), and with ground glass opacity ${\leq}$ 50% (p = 0.0073). $SUV_{max}$ > 5.0 (OR, 3.113; 95% CI, 1.375-7.049; p = 0.006) and diameter > 2.43 cm (OR, 2.799; 95% CI, 1.285-6.095; p = 0.010) were independent predictors of EGFR overexpression. Multivariate analysis showed that $SUV_{max}$ > 4.0 (hazard ratio, 10.660; 95% CI, 1.370-82.966; p = 0.024), and the presence of cavitation within a tumor (hazard ratio, 3.122; 95% CI, 1.143-8.532; p = 0.026) were factors associated with poor prognosis. Conclusion: EGFR-overexpression is associated with high $SUV_{max}$, large tumor diameter, and small GGO proportion. CT and FDG-PET findings, which are closely related to EGFR overexpression, can be valuable in the prediction of clinical outcome.

Keywords

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