PubMedOncology letters2026-07-25
Association between the presence of EGFR or ALK mutations and the location of primary non-small cell lung cancer, as well as metabolic activity observed on 18F-FDG PET/CT scans.
Biner Inci Uslu IU, Cengiz Tuba Inal TI, Yilmaz Ulku U, Akyurek Nalan N et al.
The present study aimed to determine potential differences in tumor location and metabolism among patients with non-small cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements using 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT). Data from 18F-FDG PET/CT examinations of 112 patients with NSCLC were retrospectively reviewed. The maximum standardized uptake value (SUVmax), side (right or left), lobar localization (upper, middle or lower) and location (central or peripheral) of the lung mass were recorded. Differences in age, tumor diameter, location and SUVmax between the EGFR- and ALK-positive (+) groups were assessed. ALK and EGFR positivity were detected in 25.9% (n=29) and 74.1% (n=83) of patients, respectively. Analysis revealed comparable frequencies of EGFR mutations (42.2 vs. 57.8%) and ALK rearrangements (44.8 vs. 55.2%) in peripheral and central tumors, respectively. Of the patients with ALK(+), 11 (37.9%) tumors were located on the left and 18 (62.1%) on the right, whereas in EGFR(+) patients, 39 (47.0%) were located on the left and 44 (53.0%) on the right. EGFR+ and ALK(+) tumors were more prevalent in the upper lobe (58.6 and 60.2%, respectively). No significant association was found between the side of the main tumor, lobar position, location type and the occurrence of ALK rearrangements or EGFR mutations (P=0.530, P=0.147 and P=0.975, respectively). Mutation status was not associated with median SUVmax of the primary tumor (P=0.451), No significant difference in tumor size was observed between the groups (P=0.472) and there was no association between patient age and mutation status (P=0.422). In conclusion, tumor localization and SUVmax derived from 18F-FDG PET/CT data yielded limited utility in differentiating EGFR-mutant and ALK-rearranged NSCLC. These findings should be validated in larger multicenter cohorts.