Focal 18 F-FDG uptake predicts progression of pre-invasive squamous bronchial lesions to invasive cancers

Q: What question does this study address about pre-invasive squamous bronchial lesions?

It tests whether baseline 18F-FDG PET findings can predict which pre-invasive squamous endobronchial lesions will progress to invasive lung cancer.

Q: How were patients evaluated in the study?

Patients with pre-invasive endobronchial lesions underwent an 18F-FDG PET scan, and autofluorescence bronchoscopy (AFB) was used for tissue sampling and repeated every 3 months.

Q: What did baseline PET positivity indicate for progression risk and timing?

Patients with positive baseline 18F-FDG PET had a higher proportion developing invasive lung carcinoma and a shorter median time to progression compared with PET-negative patients.

Sep 24, 2026

Uploaded by Himbo

Pre-invasive squamous lesions of central airways can advance to invasive lung cancers, making early identification of high-risk patients essential. This retrospective study evaluated whether 18F-fluorodeoxyglucose (18F-FDG) PET can predict progression in patients with pre-invasive squamous endobronchial lesions undergoing autofluorescence bronchoscopy sampling over time. From 2000–2016, PET-positive baseline patients showed more invasive lung carcinoma during follow-up, shorter time-to-progression, and overall higher risk.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Study background and rationale

Methods

Study design and patient cohort

Imaging and tissue sampling

Results

Baseline PET positivity and outcomes

Time-to-progression and survival

Conclusions

DOI: 10.1111/1759-7714.14815 ORIGINA L ARTICLE Focal 18 F-FDG uptake predicts progression of pre-invasivesquamous bronchial lesions to invasive cancers Illaa Smesseim 1 | Robert A. van Boerdonk 2 | Chris Dickhoff3 | David J. Heineman 3 | Max R. Dahele 4 | Teodora Radonic 2 | Idris Bahce 1 | Simone P. Rauh 5 | Emile F. I. Comans 6 | Hans (J. M. A.) Daniels 1 1Department of Pulmonary Diseases, Amsterdam University Medical Center, Location Free University Medical Center, Amsterdam, The Netherlands 2Department of Pathology, Amsterdam University Medical Center, Amsterdam, The Netherlands 3Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands 4Department of Radiotherapy, Amsterdam University Medical Center, Amsterdam, The Netherlands 5Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Amsterdam, The Netherlands 6Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands Correspondence Illaa Smesseim, Department of Pulmonary Diseases, Amsterdam University Medical Center, Location Free University Medical Center, Amsterdam, The Netherlands. Email: [i.smesseim@amsterdamumc.nl](i.smesseim@amsterdamumc.nl) Abstract Introduction: Pre-invasive squamous lesions of the central airways can progress into invasive lung cancers. Identifying these high-risk patients could enable detection of invasive lung cancers at an early stage. In this study, we investigated the value of 18F-fluorodeoxyglucose ( 18F-FDG) positron emission tomography (PET) scans in predicting progression in patients with pre-invasive squamous endobronchial lesions. Methods: In this retrospective study, patients with pre-invasive endobronchial lesions, who underwent an 18F-FDG PET scan at the VU University Medical Center Amsterdam, between January 2000 and December 2016, were included. Autofluorescence bronchoscopy (AFB) was used for tissue sampling and was repeated every 3 months. The minimum and median follow-up was 3 and 46.5 months. Study endpoints were the occurrence of biopsy proven invasive carcinoma, time-to-progression and overall survival (OS) . Results: A total number of 40 of 225 patients met the inclusion criteria of which 17 (42 . 5%) patients had a positive baseline 18F-FDG PET scan. A total of 13 of 17 (76.5%) developed invasive lung carcinoma during follow-up, with a median time to progression of 5.0 months (range, 3.0–25.0) . In 23 (57.5%) patients with a negative 18F-FDG PET scan at baseline, 6 (26%) developed lung cancer, with a median time to progression of 34.0 months (range, 14.0–42.0 months, p < 0.002) . With a median OS of 56.0 months (range, 9.0–60.0 months) versus 49.0 months (range, 6.0–60.0 months)(p = 0.876) for the 18F-FDG PET positive and negative groups, respectively. Conclusions: Patients with pre-invasive endobronchial squamous lesions and a positive baseline 18F-FDG PET scan were at high-risk for developing lung carcinoma, highlighting that this patient group requires early radical treatment. KEYW ORD S endobronchial, lung cancer, lung carcinoma, PET-scan, pre-invasive lesions INTRODUCTION Lung cancer is the leading cause of cancer-related death worldwide among both men and women.1 Approximately 85% of lung cancers have non–small cell histology (non– small cell lung cancers [NSCLC]), with adenocarcinoma being the predominant subtype. These tumors are typically located in the lung parenchyma. In contrast, squamous cell carcinoma (SCC) accounts for 20% to 30% of NSCLCs, and frequently originates from the central airway.1 Although in recent surgical series, a shift towards more peripherally located SCC has been observed.2,3 Nevertheless, a conservative estimate is that 􀀁 15%–20% of all lung cancers are central type squamous cancers, which therefore, constitutes a major worldwide cancer burden.4,5 SCC originates from preinvasive lesions of the airway epithelium.6 When such pre-

FAQs

What question does this study address about pre-invasive squamous bronchial lesions?

It tests whether baseline 18F-FDG PET findings can predict which pre-invasive squamous endobronchial lesions will progress to invasive lung cancer.

How were patients evaluated in the study?

Patients with pre-invasive endobronchial lesions underwent an 18F-FDG PET scan, and autofluorescence bronchoscopy (AFB) was used for tissue sampling and repeated every 3 months.

What did baseline PET positivity indicate for progression risk and timing?

Patients with positive baseline 18F-FDG PET had a higher proportion developing invasive lung carcinoma and a shorter median time to progression compared with PET-negative patients.

Sep 24, 2026

Uploaded by Himbo