The Relationship Between Parameters From 18F-FDG PET/CT And EGFR、KRAS、 ALK Mutations In NSCLC

Part 1 The relationship between ¹⁸F-FDG PET/CT and thin-section CT and EGFR mutation in lung adenocarcinoma presented as solid nodule【Objective】 The purpose of this study is to evaluate the predictive value of ¹⁸F-FDG PET/CT combined with thin-section CT findings in evaluating EGFR mutation status in lung adenocarcinoma presented as solid nodule.【Methods】We retrospectively researched 250 cases with a diagnosis of lung adenocarcinoma between November 2015 and May 2016 which underwent PET/CT and EGFR testing before treatment.We wondered to know whether there was correlation between ¹⁸F-FDG PET/CT and gene mutation.Statistical analysis was performed with Chi-square test,F-test and Student’s t-test.【Results】 The study analyzed clinical and image features about EGFR mutation.The EGFR mutation was occurred in 65.4%（n=70）of the selected patients.Gender and smoking history were independent factors in predicting EGFR mutation（p<0.001）.Female、non-smoking patients were more easily harboring EGFR mutation.Standardized uptake value（SUV max）was 9.2±0.5 in EGFR mutation patients and 10.4±0.9 in wildtype ones（p=0.090）.Other parameters,such as MTV（metabolic tumor volume）、TLG（total glucose metabolism）、Max diameter,was 21.6±2.9、119.1±19.1、3.7±0.1 and 24.3±4.1、140.7±32.4、3.9±0.2,respectively（p=0.292,p= 0.271,p=0.203）.【Conclusion】 Clinical features such as gender、smoking history,were statistical significance in predicting EGFR mutation.The mean values of parameters obtained from ¹⁸F-FDG PET/CT patients with EGFR mutation were lower than those in wild type.But distinguishes between them were no statistical significance.Correlation between F-FDG PET/CT and clinical features in patients with non-small cell lung cancer with KRAS mutation or ALK mutation【Objective】The purpose of this study is to evaluate the predictive value of FDG uptake and clinical features in evaluating KRAS and ALK mutation status in non-small cell lung cancer（NSCLC）.【Methods】We retrospectively researched 322 cases with a diagnosis of NSCLC which underwent¹⁸F-FDG PET/CT and gene testing before treatment.We wondered to know whether there were correlations between ¹⁸F-FDG PET/CT parameters and gene mutation.Statistical analysis was performed with Chi-square test,F-test and Student’s t-test.【Results】The study analyzed clinical and image features about KRAS and ALK mutation.For patients with KRAS mutation,lung adenocarcinoma are more prone to mutations（p=0.006）.¹⁸F-FDG PET/CT parameters,SUV Max Mean.±SE、SUV Ava Mean.±SE and TLG Mean.±SE in KRAS mutation patients and wildtype ones were 9.13±0.77 and 11.89±0.56,（p=0.003）、5.39±0.47 and 7.75±1.14（p=0.03）、 217.4±44.37 and 537.0±136.3（p=0.01）.For patients with ALK mutation,age is related with mutation status（p=0.02）.¹⁸F-FDG PET/CT parameters,SUV Max Mean.±SE and SUV Ava Mean.±SE in ALK mutation patients and wildtype ones were 8.52±1.37 and 11.89±0.56（p=0.04）、5.09±0.81 and 7.75±1.14（p=0.03）.【Conclusion】Pathology is statistical significance in predicting KRAS mutation while age is statistical significance with ALK mutation.Parameters obtained from ¹⁸F-FDG PET/CT,SUV Max、SUV Ava and TLG in KRAS mutation were lower than those in wild type and SUV Max and SUV Ava in ALK mutation were lower than those in wild type.All distinguishes between them were statistical significance.