Clinical response assessment on DW-MRI compared with FDG-PET/CT after neoadjuvant chemoradiotherapy in patients with oesophageal cancer

2020 ◽  
Author(s):  
Sophie E. Vollenbrock ◽  
Francine E. M. Voncken ◽  
Doenja M. J. Lambregts ◽  
Monique Maas ◽  
Maarten L. Donswijk ◽  
...  
Keyword(s):  
Clinical Response ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Response Assessment ◽  
Pet Ct ◽  
Fdg Pet Ct

PS02.064: ACCURACY OF F-18-FDG-PET/CT IN MONITORING TUMOUR RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 138-139
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Conflicts Of Interest ◽  
False Negative ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Response ◽  
Distant Metastases ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background Neoadjuvant chemoradiotherapy (nCRT) induces a pathologically complete response in approximately 30% of patients with oesophageal cancer. To explore the possibility of safe postponement of surgery, accurate clinical response evaluations are needed to exclude residual disease. The present study aims to assess the value of F-18-FDG-PET/CT for the detection of residual tumour (> 10% tumour cells = TRG3–4 vs. no vital cells = TRG1) or metastases after nCRT. Methods FDG-PET/CT at baseline and 12 weeks after nCRT was performed according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.) and the protocol of the preSANO study. Qualitative analysis included sensitive reading of presence of residual tumour and/or metastases. A lesion was considered FDG-positive, when any uptake in the lesion itself was above the adjacent oesophageal background uptake. Quantitatively, SUV/lean body mass (SUL) measurements at tumour, lymph nodes, oesophagus, liver and bloodpool were recorded and compared with pathology (resection specimen: gold standard). Results Some 129 of 207 patients with FDG-avid tumours at baseline proceeded to FDG-PET/CT at around 12 weeks after nCRT just before surgery. Forty-one of 129 patients had TRG3–4, of whom 6 were missed on FDG-PET/CT (15% false negative) with SULmax 2.07 ± 0.25, SUL-ratio tumour/oesophagus (SULR) 1.35 ± 0.14. Sensitivity for TRG2–3-4 vs. TRG1 was 57/71 (80%). SULmax and SULR of FDG-positives were 3.76 ± 1.33 and 1.82 ± 0.69 respectively, compared to SULmax 2.21 ± 0.42 and SULR 1.31 ± 0.22 in FDG-negatives. Distant metastases were detected in 18 of 190 (10%) patients. Of all patients with postponed surgery, 12 had ≥ 1 additional FDG-PET/CT during follow-up (25–49.7 weeks after nCRT). Eventually, 4 patients underwent surgery. Three of 4 had increased FDG-signal and TRG3–4; 1 patient had decreased FDG-signal and no tumour left (TRG1). Conclusion FDG-PET/CT at around 12 weeks after nCRT misses TRG3–4 tumours in 15% and detects residual TRG2–3-4 in 80%. Furthermore, PET-CT detects distant metastases in 10% of patients after nCRT. These data indicate that serial FDG-PET may become valuable in an active surveillance approach. Disclosure All authors have declared no conflicts of interest.

scholarly journals Prediction and diagnosis of interval metastasis after neoadjuvant chemoradiotherapy for oesophageal cancer using 18F-FDG PET/CT

2018 ◽  
Vol 45 (10) ◽  
pp. 1742-1751 ◽  
Author(s):  
Lucas Goense ◽  
Jelle P. Ruurda ◽  
Brett W. Carter ◽  
Penny Fang ◽  
Linus Ho ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

RA07.06: BASELINE FDG-PET/CT PARAMETERS AS PREDICTOR FOR RESIDUAL TUMOUR AFTER NEOADJUVANT CHEMORADIOTHERAPY IN OESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 35-35
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Lean Body Mass ◽  
Body Mass ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Mass ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background An optimal model for predicting pathologic response after neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer has not been defined yet. FDG-PET/CT is frequently used in response assessments. The aim of this side study of the preSANO trial (NL41732.078.13) was to investigate if the FDG-PET parameters SUVmax, total lesion glycolysis (TLG) and metabolic tumour volume (MTV) were predictive for residual tumour in the resected specimen of oesophageal cancer patients treated with nCRT. Methods Patients underwent FDG-PET/CT at baseline according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.). All parameters were corrected for lean body mass. MTV was defined as the volume within a 41% of SULmax ( = SUV/lean body mass) isocontour threshold at tumour and lymph nodes. TLG was calculated as SULmean x MTV. Logarithmic transformation was performed because of non-normal distribution of TLG and MTV. Baseline PET parameters were compared to tumour regression grade in the resection specimen (TRG3–4 = > 10% residual tumour vs. TRG1 = complete response). Peroperatively irresectable tumours were recoded as TRG4. Analyses were performed using an independent-samples T-test. Results From a total of 207 patients who underwent FDG-PET/CT before nCRT, 197 were included for analysis (5 were non-FDG avid, 5 had incomplete data). Histological type of tumour: adenocarcinoma (AC) n = 154, squamous cell carcinoma (SCC) n = 42, and one adenosquamous carcinoma. Thirty-seven patients (19%) had TRG1 and 41 patients (21%) had TRG3–4. In complete responders (TRG1), SULmax, TLG and MTV (mean ± SD) were 9.6 ± 5.8, 85.3 ± 85.5 and 13.0 ± 9.9, respectively. In patients with TRG3–4, SULmax, TLG and MTV were 9.4 ± 5.4145.8 ± 164.6 and 21.9 ± 16.2, respectively. SULmax was not significantly different between both groups (P = 0.8), but log(TLG) and log(MTV) (P = 0.008 and P = 0.001) were. In adenocarcinomas, log(TLG) did not differ between groups (P = 0.1). Conclusion Initial FDG tumour mass, expressed as MTV, (rather than SULmax) is the most contributing factor in predicting residual disease after nCRT in both SCC and AC. The effect is stronger in SCC. Therefore, baseline FDG tumour mass should be included in a prediction model, besides other clinical and tumour parameters. Disclosure All authors have declared no conflicts of interest.

Can 8 week 18F-FDG PET/CT predict clinical response in evaluation of bone metastases in breast cancer?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12539-e12539
Author(s):  
Gurdip Kaur Azad ◽  
Francois Cousin ◽  
Angela Swampillai ◽  
Benjamin P Taylor ◽  
Ines Sandri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastases ◽  
Clinical Response ◽  
Fdg Pet ◽  
De Novo ◽  
Metastatic Breast ◽  
Response Assessment ◽  
Endocrine Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

e12539 Background: 18F-FDG (fluorodeoxyglucose) PET/CT scan is widely used for staging and response assessment of metastatic breast cancer. However, the role of early treatment response assessment of bone metastases remains undefined and the optimal method not yet determined. Our hypothesis was that early 18F-FDG PET/CT can predict subsequent clinical response and our aim was to compare early 8 week 18F-FDG PET/CT with clinical response assessment up to 12 weeks in bone metastases following endocrine treatment. Methods: Eighteen patients starting endocrine treatment for de novo or progressive bone metastases were prospectively recruited. 18F-FDG PET/CT scans were performed before and 8 weeks after treatment. Percentage change in maximum SUV (SUVmax) from the same ≤ 5 index lesions was measured. Clinical response up to 12 weeks, (combination of CT/bone scintigraphy, patient symptoms, Ca-15.3), assessed by an oncologist blinded to PET imaging findings was used as a reference standard. Results: In the 4 patients with progressive disease (PD); SUVmax increased ( > 25%) in 2/20 (10%) and was stable in 15/20 (75%) lesions. Clinically, 2/4 (50%) patients had stable symptoms and 2/4 (50%) worsening bone pain at 8 and 12 weeks. Ca-153 increased ( > 40%) in 3/4 (75%) patients. Conventional imaging at 12 weeks showed PD in all 4 patients. In the 7 patients with clinical partial response (PR); SUVmax decreased ( < 25%) in 23/35 (66%) and remained stable in 10/35 (29%) lesions. Ca-153 decreased ( > 80%) in 4/7 (57%) patients. Clinically, symptoms remained stable or improved in 6/7 (86%) patients at 8 and 12 weeks. Conventional scanning at 3 months showed either PR (n = 3) or SD (n = 4). In the 7 patients with stable disease (SD); SUVmax remained unchanged in 15/27 (56%) and decreased in 12/27 (44%) lesions. Ca-153 showed minimal changes in 6/7 (86%) patients. Conventional scans showed SD in all 7 patients. Conclusions: Our data show that although 18F-FDG PET/CT is reliable at predicting PR or SD, it has poorer predictive ability for clinical PD in bone metastases at 8 weeks. Intra-patient heterogeneity of response between lesions is a common observation. Clinical trial information: 12/LO/1801.

Detecting Interval Metastases and Response Assessment Using 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Esophageal Cancer

2014 ◽  
Vol 39 (10) ◽  
pp. 862-867 ◽  
Author(s):  
Jurriën Stiekema ◽  
Daan Vermeulen ◽  
Erik Vegt ◽  
Francine E.M. Voncken ◽  
Berthe M.P. Aleman ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Response Assessment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Semi-quantitative measurements of chemokine receptor 4-targeted 68Ga-pentixafor PET/CT in response assessment of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qingqing Pan ◽  
Xinxin Cao ◽  
Yaping Luo ◽  
Jian Li ◽  
Fang Li
Keyword(s):  
Partial Response ◽  
Clinical Response ◽  
Fdg Pet ◽  
Response Assessment ◽  
Lymphoplasmacytic Lymphoma ◽  
Monoclonal Protein ◽  
Quantitative Measurements ◽  
Waldenstrom Macroglobulinemia ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose 68Ga-pentixafor PET/CT was reported to have a high sensitivity in detecting tumor involvement of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) in our previous study. We aimed to further investigate the semi-quantitative measurements of 68Ga-pentixafor PET/CT in response assessment in WM/LPL. Methods Fifteen patients with WM/LPL were recruited in a prospective cohort study and underwent both 68Ga-pentixafor and 18F-FDG PET/CT at baseline and post-treatment. PET/CT-based responses were analyzed with semi-quantitative assessments of metabolic tumor volume (MTV) and total lesions glycolysis/uptake (TLGFDG and TLUCXCR4), and the correlation between PET/CT-based response and clinical response, monoclonal protein and IgM response was analyzed. Results After chemotherapy, 5 patients had complete response or very good partial response, 8 had partial response or minimal response and 2 had progressive disease. In quantitative analysis, 68Ga-pentixafor PET/CT-based response (measured in ∆TLUCXCR4%, ∆MTVCXCR4%, ∆SUVpeak%) showed a significant direct correlation with clinical response, monoclonal protein and IgM response (p < 0.01). However, 18F-FDG PET/CT-based response was independent from clinical response (p > 0.05). Conclusions The semi-quantitative measurements of 68Ga-pentixafor PET/CT outperformed 18F-FDG PET/CT in response assessment of WM/LPL.

scholarly journals Usefulness of 18f-FDG PET-CT in Staging, Restaging, and Response Assessment in Pediatric Rhabdomyosarcoma

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1112
Author(s):  
Davide Donner ◽  
Paola Feraco ◽  
Linda Meneghello ◽  
Barbara Rombi ◽  
Lorena Picori ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Pediatric Patients ◽  
Response Assessment ◽  
Response To Therapy ◽  
High Morbidity ◽  
European Guidelines ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Clinical Advances

Rhabdomyosarcoma is the most common soft-tissue sarcoma of childhood. Despite clinical advances, subsets of these patients continue to suffer high morbidity and mortality rates associated with their disease. Following the European guidelines for 18F-FDG PET and PET-CT imaging in pediatric oncology, the routine use of 18F-FDG PET-CT may be useful for patients affected by rhabdomyosarcoma, in staging, in the evaluation of response to therapy, and for restaging/detection of relapse. The European Pediatric Protocols are very old, and for staging and restaging, they recommend only radionuclide bone scan. The 18F-FDG PET-CT exam is listed as an optional investigation prescribed according to local availability and local protocols in the investigations panel required at the end of the treatment. We present two cases highlighting the usefulness of 18F-FDG PET-CT in managing pediatric patients affected by rhabdomyosarcoma, providing some bibliographic references.

Clinical implications of initial FDG-PET/CT in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy

2013 ◽  
Vol 71 (5) ◽  
pp. 1201-1207 ◽  
Author(s):  
Soo Jung Lee ◽  
Jong Gwang Kim ◽  
Sang-Woo Lee ◽  
Yee Soo Chae ◽  
Byung Woog Kang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Clinical Implications ◽  
Pet Ct ◽  
Fdg Pet Ct

PH-0040: A 6-point scale approach to 18F-FDG PET-CT for response assessment in HNSCC: a multicenter study

2020 ◽  
Vol 152 ◽  
pp. S11-S12
Author(s):  
P. Bonomo ◽  
A. Merlotti ◽  
S. Morbelli ◽  
V. Berti ◽  
C. Saieva ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Fdg Pet ◽  
Response Assessment ◽  
Point Scale ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct
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