The relationship of PET/CT SUVmax with EGFR mutation status and ALK rearrangement in lung adenocarcinoma

Objective: Epidermal growth factor receptor mutations (EGFRm) and rearrangement of the anaplastic lymphoma kinase gene (ALKr) can be targeted for precision therapy in lung adenocarcinoma (LADC). As molecular profiling is not available for all, patient stratification can be achieved using non-invasive and economic tools, such as positron emission tomography/computed tomography (PET/CT). We aimed to evaluate the relationships between fluorine-18-fluorodeoxyglucose (F-18-FDG) PET/CT maximum standardized uptake value (SUVmax) of primary tumors (pSUVmax) and lymph nodes (nSUVmax) and the EGFRm and ALKr status in a large series of Turkish LADC patients. Materials and Methods: In this retrospective study, medical records of histopathologically confirmed LADC patients were reviewed for demographic and clinical data.The F-18-FDG PET/CT pSUVmax nSUVmax were calculated and analyzed for their relationships with EGFRm and ALKr using multiple regression analysis. Results: The study population consisted of 732 LADC patients with a mean age of 63 +/- 10 years. The frequencies of EGFRm and ALKr were 10.4% and 3.6%, respectively. Female gender, being a former- or never-smoker for EGFRm and age for ALKr were determined as independent risk factors (P<0.05). No significant differences in pSUVmax and nSUVmax were present between the patients with either EGFRm or ALKr compared to the wild-type genotype patients (P>0.05). Conclusions:We conclude that F-18-F DO PET/CT semi-quantitative parameter SUVmax could not be validated for the prediction of the EGF Rm or the ALKr in our large series of 732 Turkish patients with LADC.