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Martin, Ole; Bruckmann, Nils-Martin; Kirchner, Julian; Ullrich, Tim; Ingenwerth, Marc; Bogner, Simon; Eze, Chukwuka; Nensa, Felix; Herrmann, Ken; Umutlu, Lale; Antoch, Gerald; Sawicki, Lino M. (2020): Is there a connection between immunohistochemical markers and grading of lung cancer with apparent diffusion coefficient (ADC) and standardised uptake values (SUV) of hybrid 18F-FDG-PET/MRI? In: Journal of Medical Imaging and Radiation Oncology, Vol. 64, No. 6: pp. 779-786
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Introduction: To correlate tumour grading and prognostic immunohistochemical markers of lung cancer with simultaneously acquired standardised uptake values (SUV) and apparent diffusion coefficient (ADC) derived from hybrid PET/MRI. Methods In this retrospective study, 55 consecutive patients (mean age 62.5 +/- 9.2 years) with therapy-naive, histologically proven lung cancer were included. All patients underwent whole-body PET/MRI using 18F-flourdeoxyglucose (18F-FDG) as a radiotracer. Diffusion-weighted imaging of the chest (DWI, b-values: 0, 500, 1000 s/mm(2)) was performed simultaneously with PET acquisition. Histopathological tumour grading was available in 43/55 patients. In 15/55 patients, immunohistochemical markers, that is, phospho-AKT Ser473 (pAKTS473), phosphorylated extracellular signal-regulated kinase (pERK), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (erbB2) were available. Results The average SUVmax, SUVmean, ADCmin and ADCmean in lung cancer primaries were 12.6 +/- 5.9, 7.7 +/- 4.6, 569.9 +/- 96.1 s/mm(2)and 825.8 +/- 93.2 s/mm(2), respectively. We found a significant inverse correlation between the ADCmin and SUVmax (r = -0.58,P < 0.001) as well as between the ADCmin and SUVmean (r = -0.44,P < 0.001). Tumour grading showed a significant positive correlation with SUVmax and SUVmean (R = 0.34 andR = 0.31, bothP < 0.05) and a significant inverse correlation with ADCmin and ADCmean (r = -0.30 andr = -0.40, bothP < 0.05). In addition, erbB2 showed a significant inverse correlation with SUVmax and SUVmean (r = -0.50 andr = -0.49, bothP < 0.05). The other immunohistochemical markers did not show any significant correlation. Conclusion 18F-FDG-PET/MRI showed weak to moderate correlations between SUV, ADC, tumour grading and erbB2-expression of lung cancer. Hence, 18F-FDG-PET/MRI may, to some extent, offer complementary information to the histopathology of lung cancer, for the evaluation of tumour aggressiveness and treatment response.