Original Study| Volume 24, ISSUE 2, P107-113, March 2023

Distinct Prognostic Impact of PET Findings Based on Radiological Appearance in Clinical Stage IA Lung Adenocarcinoma

Published:November 18, 2022DOI:



      Although solid appearance on computed tomography and positive findings on positron emission tomography (PET) have been both associated with poor outcome in lung adenocarcinoma, the extent to which these findings overlap is unknown. This study aimed to determine the differences in prognostic significance of PET findings in part-solid nodules (PSNs) and solid nodules.

      Materials and Methods

      We retrospectively investigated 417 patients with clinical stage IA adenocarcinoma who underwent curative resection between 2010 and 2017. We compared disease-free survival (DFS), cumulative incidence of disease recurrence (CIR) and clinicopathological characters between PET-positive and negative groups among PSNs and solid nodules, respectively. We used 2.5 as a cut-off value of maximum standardized uptake value (SUV max).


      In PSNs (n = 235), PET-positive group (n = 59) showed more aggressive features in several clinicopathological variables, poorer DFS (P < .001) and higher CIR (P < .001) than PET-negative group (n = 176). In contrast, in solid nodules (n = 182), DFS (P = .521) and CIR (P = .311) were not significantly different between PET-positive (n = 128) and negative groups (n = 54). SUV max was proved to be the independent prognostic factor of DFS by multivariate analysis (HR, 1.155; 95% CI, 1.036-1.287) only in PSNs.


      These findings showed distinct impact on prognosis of PET findings between PSNs and solid nodules. PET-positive finding was more important prognostic factor in PSNs than in solid nodules among clinical stage IA lung adenocarcinoma.



      AIS (adenocarcinoma in situ), CEA (carcinoembryonic antigen), CT (computed tomography), CIR (cumulative incidence of disease recurrence), DFS (Disease-free survival), EGFR (Epidermal growth factor receptor), FDG ([18F]-fluorodeoxyglucose), GGO (ground glass opacity), HRCT (high-resolution computed tomography), IQR (interquartile range), LVI (lymphovascular involvement), MIA (minimally-invasive adenocarcinoma), OS (overall survival), PET (positron emission tomography), PSN (part-solid nodule), SUVmax (maximum standardized uptake value)
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