The maximum uptake of 18F-deoxyglucose on positron emission tomography scan correlates with survival, hypoxia inducible factor-1α and GLUT-1 in non-small cell lung cancer

The purpose of this study was to investigate the relation between the standardised uptake value (SUV) on 18F-fluoro-2-deoxy-glucose-positron emission tomography scan and hypoxia related markers (HIF-1α and CAIX), a proliferation-related marker (Ki-67) and glucose transporters (GLUT-1 and GLUT-3) in non-small cell lung cancer (NSCLC). One hundred and two patients, scheduled for complete resection, received a PET scan in Leuven or Maastricht/Aachen. The maximal SUV (SUVmax) was correlated with survival and immunohistochemical staining patterns. The actuarial survival was worse for patients showing a high SUVmax, the best discriminative value being 8.0 (Leuven, p = 0.032) and 11.0 (Maastricht, p = 0.007). Tumours with a high SUVmax expressed in a higher proportion HIF-1α (63.1% versus 37.9%, p = 0.024) and GLUT-1 (82.9% versus 62.5%, p = 0.025), than tumours with a low SUVmax. No significant difference was found in the expression of CAIX, Ki-67 and GLUT-3. This study supports preclinical data that hypoxia is associated with a higher uptake of FDG.