The Prediction of Spread Through Air Spaces with Preoperative 18F-FDG PET/CT in Clinical Stage I Lung Carcinoma

Kocaman G., Soydal Ç., Dursun Ş., Kahya Y., Sak S., Kayı Cangır A.

34th Annual Meeting of Asian Society for Cardiovascular and Thoracic Surgery, Antalya, Türkiye, 16 - 19 Nisan 2026, ss.5, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.5
  • Ankara Üniversitesi Adresli: Evet

Özet

Objectives:

The aim of this retrospective study was to investigate the utility of preoperative F-18

fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)

in predicting STAS in clinical stage I lung carcinoma (LC).

Methods:

The study included 188 patients with clinical Stage I LC who underwent surgery, had

preoperative 18F-FDG PET/CT imaging available at our institution, and did not receive

neoadjuvant treatment between 2016 and 2024. Maximum standardized uptake value (SUVmax),

metabolic tumor volume (MTV), and total lesion glycolysis (TLG) values were calculated from

preoperative 18F-FDG PET/CT images. Additionally, ROIs with 3 mm diameter were drawn

within the 1 cm distance of primary tumors to evaluate the possible SUVmax and SUVmean

changes in the area where STAS is searched for and SUVmax-1cm and SUVmean-1cm were

calculated. Patients were grouped as STAS negative (STAS-) and positive (STAS+) with

postsurgical histopathological examination. Differences between 18F-FDG PET/CT parameters

of STAS- and STAS+ groups were compared using the Mann-Whitney U Test.

Results:

188 patients (mean age: 62.73; 120, 63.8% male) with clinical Stage I LC included to the

analysis. Based on the histopathological examination, 71 (37.8%) were STAS+. Patient groups

with T1c-T2a tumors, N1-2 nodal disease, present lymphovascular invasion and high grade

tumors had a significant high incidence of STAS positivity. The STAS positivity rate for FDG

avid lesions were significantly higher than non-avid ones (53/123, 43.1% vs 18/65 27.7%,

p=0.038). Significant differences were detected in medians of SUVmax (6.4 vs 4.3, p = 0.034),

SUVmean (3.8 vs 2.2, p=0.026) and TLG (11.2 vs 7.2, p=0.049) between groups according to

the presence of STAS.

Conclusion:

Clinical stage I LCs with STAS, exhibit higher metabolic activity on preoperative ¹⁸F-FDG

PET/CT. These findings suggest that ¹⁸F-FDG PET/CT may contribute to the preoperative

prediction of STAS and assist in selecting the most appropriate surgical strategy.