Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma

Abstract Background The exploration of biomarkers is of crucial importance for the prognosis of cancer patients. The objective of this study was to ascertain the predictive value of positron emission tomography (PET) image-derived biomarkers, specifically the normalized distances from the hot spot o...

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Main Authors: Cheng Zheng, Jiangfeng Miao, LiuWei Xu, Yujie Cai, BingShu Zheng, ZhongHua Tan, ChunFeng Sun
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14263-0
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author Cheng Zheng
Jiangfeng Miao
LiuWei Xu
Yujie Cai
BingShu Zheng
ZhongHua Tan
ChunFeng Sun
author_facet Cheng Zheng
Jiangfeng Miao
LiuWei Xu
Yujie Cai
BingShu Zheng
ZhongHua Tan
ChunFeng Sun
author_sort Cheng Zheng
collection DOAJ
description Abstract Background The exploration of biomarkers is of crucial importance for the prognosis of cancer patients. The objective of this study was to ascertain the predictive value of positron emission tomography (PET) image-derived biomarkers, specifically the normalized distances from the hot spot of radiotracer uptake to the tumor centroid (NHOC) and the tumor perimeter (NHOP), in forecasting the recurrence risk and disease-free survival (DFS) in patients with operable stage IA–IIIA lung adenocarcinoma (LUAD). Methods A retrospective analysis was conducted on 164 patients with surgically treated pathologically confirmed stage IA–IIIA LUAD, all of whom had prior 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) scans. In addition to conventional PET/CT parameters, we assessed the normalized distances from the maximum SUV to both the tumor centroid (NHOCmax) and the tumor perimeter (NHOPmax) as observed in the PET/CT images. Results A total of 164 patients were included, with a median age of 65 years. NHOPmax exhibited the highest AUC of 0.682 (95% CI: 0.578–0.785), with a sensitivity of 78.8%. Correlation analysis showed that NHOPmax had low correlations with other metabolic parameters such as SUVmax, TLG, and MTV. In both univariate and multivariate analyses, NHOPmax was significantly associated with postoperative outcomes (P < 0.001, odds ratio 0.033). Survival analysis indicated that NHOPmax was an independent predictor of DFS (HR = 0.399, P < 0.05), with higher NHOPmax (> 0.43) associated with significantly better survival (P < 0.0001). Conclusion NHOPmax quantified from 18F-FDG PET/CT scans, could be a promising predictor of postoperative recurrence in patients with resectable LUAD.
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spelling doaj-art-72997ad789fd4b8bb50ac299fd92ae4e2025-08-20T03:53:58ZengBMCBMC Cancer1471-24072025-05-0125111010.1186/s12885-025-14263-0Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinomaCheng Zheng0Jiangfeng Miao1LiuWei Xu2Yujie Cai3BingShu Zheng4ZhongHua Tan5ChunFeng Sun6Department of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictDepartment of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan DistrictAbstract Background The exploration of biomarkers is of crucial importance for the prognosis of cancer patients. The objective of this study was to ascertain the predictive value of positron emission tomography (PET) image-derived biomarkers, specifically the normalized distances from the hot spot of radiotracer uptake to the tumor centroid (NHOC) and the tumor perimeter (NHOP), in forecasting the recurrence risk and disease-free survival (DFS) in patients with operable stage IA–IIIA lung adenocarcinoma (LUAD). Methods A retrospective analysis was conducted on 164 patients with surgically treated pathologically confirmed stage IA–IIIA LUAD, all of whom had prior 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) scans. In addition to conventional PET/CT parameters, we assessed the normalized distances from the maximum SUV to both the tumor centroid (NHOCmax) and the tumor perimeter (NHOPmax) as observed in the PET/CT images. Results A total of 164 patients were included, with a median age of 65 years. NHOPmax exhibited the highest AUC of 0.682 (95% CI: 0.578–0.785), with a sensitivity of 78.8%. Correlation analysis showed that NHOPmax had low correlations with other metabolic parameters such as SUVmax, TLG, and MTV. In both univariate and multivariate analyses, NHOPmax was significantly associated with postoperative outcomes (P < 0.001, odds ratio 0.033). Survival analysis indicated that NHOPmax was an independent predictor of DFS (HR = 0.399, P < 0.05), with higher NHOPmax (> 0.43) associated with significantly better survival (P < 0.0001). Conclusion NHOPmax quantified from 18F-FDG PET/CT scans, could be a promising predictor of postoperative recurrence in patients with resectable LUAD.https://doi.org/10.1186/s12885-025-14263-0Lung adenocarcinoma18F-FDG PET/CTPrognosis
spellingShingle Cheng Zheng
Jiangfeng Miao
LiuWei Xu
Yujie Cai
BingShu Zheng
ZhongHua Tan
ChunFeng Sun
Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
BMC Cancer
Lung adenocarcinoma
18F-FDG PET/CT
Prognosis
title Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
title_full Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
title_fullStr Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
title_full_unstemmed Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
title_short Novel PET imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
title_sort novel pet imaging biomarkers as predictors of postoperative recurrence in lung adenocarcinoma
topic Lung adenocarcinoma
18F-FDG PET/CT
Prognosis
url https://doi.org/10.1186/s12885-025-14263-0
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