WCLC 2025 - Posters & ePosters-EP.04.18 Preoperative Prediction of Grade 3 Invasive Non-Mucinous Adenocarcinoma Using Semiconductor 18F-FDG-PET/CT: A Diagnostic Accuracy Study

EP.04.18 Preoperative Prediction of Grade 3 Invasive Non-Mucinous Adenocarcinoma Using Semiconductor 18F-FDG-PET/CT: A Diagnostic Accuracy Study

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This diagnostic accuracy study from Tohoku University investigated the utility of semiconductor 18F-FDG-PET/CT (sPET/CT) for preoperatively predicting Grade 3 invasive non-mucinous adenocarcinoma (INMA), a subtype of non-small cell lung cancer (NSCLC) associated with poor prognosis per the 2021 WHO three-tier grading system. Accurate preoperative identification of Grade 3 tumors is critical to guide personalized treatment strategies, such as deciding on neoadjuvant therapy and tailoring surgical approaches.<br /><br />The study retrospectively analyzed 550 patients with resected INMA between 2010 and 2022, divided into conventional PET/CT (cPET/CT, n=328) and semiconductor PET/CT (sPET/CT, n=222) cohorts. Patients were excluded if they had other histological types, neoadjuvant therapy, sublobar/incomplete resections, diabetes treatment, or lacked preoperative PET/CT imaging. Tumors were graded histologically based on the proportion of high-grade components following the WHO classification.<br /><br />Using statistical tests and ROC curve analysis to evaluate the maximum standardized uptake value (SUVmax) as a predictor of Grade 3 status, sPET/CT demonstrated significantly improved diagnostic accuracy over cPET/CT for identifying Grade 3 INMA preoperatively. This superior spatial resolution of sPET/CT enhanced the ability to distinguish aggressive tumor histology.<br /><br />The findings suggest that sPET/CT can improve personalized treatment planning for early-stage NSCLC patients by reliably identifying high-grade tumors before surgery. This can influence decisions about neoadjuvant therapy administration and the extent of surgical resection, ultimately aiming to improve patient outcomes.<br /><br />In conclusion, semiconductor 18F-FDG-PET/CT offers a more precise, non-invasive preoperative diagnostic tool for detecting Grade 3 invasive non-mucinous adenocarcinoma, supporting more tailored clinical management strategies in lung cancer care.

Asset Subtitle

Hirotsugu Notsuda

Meta Tag

Speaker Hirotsugu Notsuda

Topic Screening and Early Detection

Keywords

semiconductor PET/CT

18F-FDG-PET/CT

Grade 3 invasive non-mucinous adenocarcinoma

non-small cell lung cancer

diagnostic accuracy

maximum standardized uptake value (SUVmax)

preoperative prediction

personalized treatment planning

neoadjuvant therapy

surgical resection