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Abstract
This study investigated the associations between image features extracted from tumor 18F-fluorodeoxyglucose (FDG) uptake and genetic alterations in patients with lung cancer. A total of 137 patients (age, 62.7 ± 10.2 years) who underwent FDG positron emission tomography/computed tomography (PET/CT) and targeted deep sequencing analysis for a tumor lesion, comprising 61 adenocarcinoma (ADC), 31 squamous cell carcinoma (SQCC), and 45 small cell lung cancer (SCLC) patients, were enrolled in this study. From the tumor lesions, 86 image features were extracted, and 381 genes were assessed. PET features were associated with genetic mutations: 41 genes with 24 features in ADC; 35 genes with 22 features in SQCC; and 43 genes with 25 features in SCLC (FDR < 0.05). Clusters based on PET features showed an association with alterations in oncogenic signaling pathways: Cell cycle and WNT signaling pathways in ADC (p = 0.023, p = 0.035, respectively); Cell cycle, p53, and WNT in SQCC (p = 0.045, 0.009, and 0.029, respectively); and TGFβ in SCLC (p = 0.030). In addition, SUVpeak and SUVmax were associated with a mutation of the TGFβ signaling pathway in ADC (FDR = 0.001, < 0.001). In this study, PET image features had significant associations with alterations in genes and oncogenic signaling pathways in patients with lung cancer.

Affiliations

Gahyun Kim  1   2 , Jinho Kim  1 , Hongui Cha  1   2 , Woong-Yang Park  3 , Jin Seok Ahn  4 , Myung-Ju Ahn  4 , Keunchil Park  4 , Yong-Jin Park  5 , Joon Young Choi  5 , Kyung-Han Lee  5 , Se-Hoon Lee  6   7 , Seung Hwan Moon  8
1 Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea.
2 Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
3 Samsung Genome Institute, Samsung Medical Center, Samsung Advanced Institute of Health Science and Technology, Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
4 Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
5 Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Seoul, Republic of Korea.
6 Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. sehoon.lee@samsung.com.
7 Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. sehoon.lee@samsung.com.
8 Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Seoul, Republic of Korea. seunghwan.moons.moon@samsung.com.