Correlation of 18F-FDG PET/CT SUV with Colon Cancer Aggressiveness and Superior Diagnostic Performance Over CT for Lymph Node Metastasis: A Retrospective Analysis

Haibo Chen,1,2 Yuqi Chen,1,2 Yaqi Feng,1,2 Yanqiong He,1,2 Yan Xu,1,2 Yushuang Qin,1,2 Peng Wang1,2 1Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China; 2Department of Nuclear Medicine, Yichang Central People’s Hospital, Yichang, Hubei, 443003, People’s Republic of ChinaCorrespondence: Peng Wang, Email [email protected]: To analyze the relationship between the standardized uptake value (SUV) derived from 18F-FDG PET/CT imaging and the clinical characteristics of colon cancer, and to evaluate its diagnostic performance relative to CT imaging in identifying lymph node metastasis.Methods: A retrospective analysis was conducted on 113 patients with pathologically confirmed primary colon cancer. All patients underwent preoperative 18F-FDG PET/CT and CT examinations. The SUV of the primary lesion was measured. Patients were grouped based on clinicopathological features, and differences in SUV across groups were analyzed. The diagnostic efficacy of PET/CT and CT for lymph node metastasis was evaluated using receiver operating characteristic (ROC) curves, with pathology as the gold standard.Results: The lesion SUV was not significantly related to sex, age, lesion location, CA199, or CA242 (P > 0.05). However, it was significantly associated with maximum lesion diameter (P < 0.001), AJCC stage (P = 0.001), pathological type (P < 0.001), differentiation grade (P < 0.001), lymph node metastasis (P < 0.001), and CEA expression (P < 0.001). Spearman correlation analysis showed that SUV was positively correlated with these significant parameters (all P < 0.05). For diagnosing lymph node metastasis, the area under the curve (AUC) for 18F-FDG PET/CT imaging was 0.943, which was significantly higher than that for CT imaging (0.836) (Z = 3.965, P < 0.05), with superior sensitivity and specificity.Conclusion: SUV values on 18F-FDG PET/CT are positively correlated with key indicators of tumor aggressiveness in colon cancer, including tumor size, stage, differentiation grade, and lymph node metastasis. 18F-FDG PET/CT demonstrates significantly better diagnostic performance than CT alone for the detection of lymph node metastasis.Keywords: 18F-FDG PET/CT, SUV, colon cancer, clinical features, diagnostic efficacy