Correlation of FDG-PET findings with histopathology in the assessment of response to induction chemoradiotherapy in non-small cell lung cancer

Eur J Nucl Med Mol Imaging. 2006 Feb;33(2):140-7. doi: 10.1007/s00259-005-1878-9. Epub 2005 Oct 12.


Purpose: The objective of this study was to evaluate the ability of FDG-PET to predict the response of primary tumour and nodal disease to preoperative induction chemoradiotherapy in patients with non-small cell lung cancer (NSCLC).

Methods: FDG-PET studies were performed before and after completion of chemoradiotherapy prior to surgery in 26 patients with NSCLC. FDG-PET imaging was performed at 1 h (early) and 2 h (delayed) after injection. Semi-quantitative analysis was performed using the standardised uptake value (SUV) at the primary tumour. Percent change was calculated according to the following equation: [see text]. Based on histopathological analysis of the specimens obtained at surgery, patients were classified as pathological responders or pathological non-responders. The clinical nodal stage on the post-chemoradiotherapy PET scan was visually determined and compared with the final pathological stage.

Results: Eighteen patients were found to be pathological responders and eight to be pathological non-responders. SUV(after) values from both early and delayed images in pathological responders were significantly lower than those in pathological non-responders. The percent change values from early and delayed images in the pathological responders were significantly higher than those in the pathological non-responders. The post-chemoradiotherapy PET scan accurately predicted nodal stage in 22 of 26 patients.

Conclusion: FDG-PET may have the potential to predict response to induction chemoradiotherapy in patients with NSCLC.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Processing, Computer-Assisted
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging / methods
  • Positron-Emission Tomography / methods*
  • Time Factors


  • Antineoplastic Agents
  • Fluorodeoxyglucose F18