PET imaging can identify the underlying cell mutations that cause non-small cell lung cancer, according to a new study published in The Journal of Nuclear Medicine. That information can help physicians select the optimal treatment plan for each patient.

“To our knowledge, this is the first study to investigate the relationship between somatic mutations and the metabolic phenotypes, which may provide valuable information for developing noninvasive imaging biomarkers for determining mutation status,” Stephen Yip, one of the researchers and instructor at Harvard Medical School, said in a statement.

NSCLC is the most common type of lung cancer, accounting for 80 to 85 percent of all lung cancer diagnoses, according to the American Society of Clinical Oncology. An estimated 222,500 adults in the U.S. will be diagnosed with lung cancer this year.
Molecular testing that involves either biopsies of the tumor tissue or surgical resection is the current standard for determining mutation status. But it’s an invasive, time-consuming procedure and tissue samples are not always readily available.

For the study, the researchers had 348 patients with NSCLC undergo diagnostic F-18-FDG PET exams to be tested for genetic mutations. They found that 13 percent of the patients had an epidermal growth factor receptor mutation and 28 percent had a Kristen rat sarcoma vital mutation.

The researchers concluded that EGFR mutations may drive different metabolic tumor phenotypes that were shown in the PET images, but KRAS-mutated tumors do not.

“This study may, thus, help develop an imaging biomarker that can noninvasively and accurately identify EGFR mutation status using PET imaging to complement, but not to replace, molecular testing,” said Yip.

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