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 <sup>18</sup>F‑FDG PET/CT scans

Biner,Inci Uslu; Cengiz,Tuba Inal; Yilmaz,Ulku; Akyurek,Nalan; Kavurgaci,Suna; Kabalak,Pinar Akin; Kizilgoz,Derya; Akan,Ezgi Gurel

doi:10.3892/ol.2026.15764

September-2026 Volume 32 Issue 3

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September-2026 Volume 32 Issue 3

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Article Open Access

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

Authors:
- Inci Uslu Biner
- Tuba Inal Cengiz
- Ulku Yilmaz
- Nalan Akyurek
- Suna Kavurgaci
- Pinar Akin Kabalak
- Derya Kizilgoz
- Ezgi Gurel Akan
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Affiliations: Department of Nuclear Medicine, Eskişehir Osmangazi University, Eskişehir 26040, Turkiye, Department of Chest Diseases, Atatürk Sanatorium Training and Research Hospital, Ankara 06290, Turkiye, Department of Pathology, Gazi University, Ankara 06500, Turkiye

Copyright: © Biner et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Article Number: 409
|
Published online on: July 14, 2026

https://doi.org/10.3892/ol.2026.15764
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Abstract

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.

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