scholarly journals Tumor response evaluation in patients with malignant melanoma undergoing immune checkpoint inhibitor therapy and prognosis prediction using 18F-FDG PET/CT: multicenter study for comparison of EORTC, PERCIST, and imPERCIST

2021 ◽  
Author(s):  
Kazuhiro Kitajima ◽  
Tadashi Watabe ◽  
Masatoyo Nakajo ◽  
Mana Ishibashi ◽  
Hiromitsu Daisaki ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Malignant Melanoma ◽  
Fdg Pet ◽  
Immune Checkpoint Inhibitor ◽  
Metabolic Response ◽  
Checkpoint Inhibitor ◽  
Response Evaluation ◽  
Pet Ct ◽  
Melanoma Patients ◽  
Fdg Pet Ct

Abstract Objective In malignant melanoma patients treated with immune checkpoint inhibitor (ICI) therapy, three different FDG-PET criteria, European Organization for Research and Treatment of Cancer (EORTC), PET Response Criteria in Solid Tumors (PERCIST), immunotherapy-modified PERCIST (imPERCIST), were compared regarding response evaluation and prognosis prediction using standardized uptake value (SUV) harmonization of results obtained with various PET/CT scanners installed at different centers. Materials and methods Malignant melanoma patients (n = 27) underwent FDG-PET/CT examinations before and again 3 to 9 months after therapy initiation (nivolumab, n = 21; pembrolizumab, n = 6) with different PET scanners at five hospitals. EORTC, PERCIST, and imPERCIST criteria were used to evaluate therapeutic response, then concordance of the results was assessed using Cohen’s κ coefficient. Log-rank and Cox methods were employed to determine progression-free (PFS) and overall (OS) survival. Results Complete metabolic response (CMR)/partial metabolic response (PMR)/stable metabolic disease (SMD)/progressive metabolic disease (PMD) with harmonized EORTC, PERCIST, and imPERCIST was seen in 3/5/4/15, 4/5/3/15, and 4/5/5/13 patients, respectively. Nearly perfect concordance between each pair of criteria was noted (κ = 0.939–0.972). Twenty patients showed progression and 14 died from malignant melanoma after a median 19.2 months. Responders (CMR/PMR) showed significantly longer PFS and OS than non-responders (SMD/PMD) (harmonized EORTC: p < 0.0001 and p = 0.011; harmonized PERCIST: p < 0.0001 and p = 0.0012; harmonized imPERCIST: p < 0.0001 and p = 0.0012, respectively). Conclusions All harmonized FDG-PET criteria (EORTC, PERCIST, imPERCIST) showed accuracy for response evaluation of ICI therapy and prediction of malignant melanoma patient prognosis. Additional studies to determine their value in larger study populations will be necessary.

scholarly journals Interrater Agreement and Reliability of PERCIST and Visual Assessment When Using 18F-FDG-PET/CT for Response Monitoring of Metastatic Breast Cancer

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1001
Author(s):  
Jonas S. Sørensen ◽  
Mie H. Vilstrup ◽  
Jorun Holm ◽  
Marianne Vogsen ◽  
Jakob L. Bülow ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Metabolic Response ◽  
Metastatic Breast ◽  
Visual Assessment ◽  
Interrater Agreement ◽  
Qualitative Assessment ◽  
Response Evaluation ◽  
Substantial Agreement ◽  
Pet Ct ◽  
Fdg Pet Ct

Response evaluation at regular intervals is indicated for treatment of metastatic breast cancer (MBC). FDG-PET/CT has the potential to monitor treatment response accurately. Our purpose was to: (a) compare the interrater agreement and reliability of the semi-quantitative PERCIST criteria to qualitative visual assessment in response evaluation of MBC and (b) investigate the intrarater agreement when comparing visual assessment of each rater to their respective PERCIST assessment. We performed a retrospective study on FDG-PET/CT in women who received treatment for MBC. Three specialists in nuclear medicine categorized response evaluation by qualitative assessment and standardized one-lesion PERCIST assessment. The scans were categorized into complete metabolic response, partial metabolic response, stable metabolic disease, and progressive metabolic disease. 37 patients with 179 scans were included. Visual assessment categorization yielded moderate agreement with an overall proportion of agreement (PoA) between raters of 0.52 (95% CI 0.44–0.66) and a Fleiss kappa estimate of 0.54 (95% CI 0.46–0.62). PERCIST response categorization yielded substantial agreement with an overall PoA of 0.65 (95% CI 0.57–0.73) and a Fleiss kappa estimate of 0.68 (95% CI 0.60–0.75). The difference in PoA between overall estimates for PERCIST and visual assessment was 0.13 (95% CI 0.06–0.21; p = 0.001), that of kappa was 0.14 (95% CI 0.06–0.21; p < 0.001). The overall intrarater PoA was 0.80 (95% CI 0.75–0.84) with substantial agreement by a Fleiss kappa of 0.74 (95% CI 0.69–0.79). Semi-quantitative PERCIST assessment achieved significantly higher level of overall agreement and reliability compared with qualitative assessment among three raters. The achieved high levels of intrarater agreement indicated no obvious conflicting elements between the two methods. PERCIST assessment may, therefore, give more consistent interpretations between raters when using FDG-PET/CT for response evaluation in MBC.

Immune checkpoint inhibitor related adverse effects and FDG PET/CT findings

2021 ◽  
pp. jnmt.121.262151
Author(s):  
Jan-Henning Schierz ◽  
Ismet Sarikaya ◽  
Uwe Wollina ◽  
Leonore Unger ◽  
Ali Sarikaya
Keyword(s):  
Adverse Effects ◽  
Immune Checkpoint ◽  
Fdg Pet ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Ct Findings ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Prediction of response to immune checkpoint inhibitor therapy using 18F-FDG PET/CT in patients with melanoma

Medicine ◽  
2019 ◽  
Vol 98 (29) ◽  
pp. e16417 ◽  
Author(s):  
Karim Amrane ◽  
Delphine Le Goupil ◽  
Gilles Quere ◽  
Olivier Delcroix ◽  
Sylvie Gouva ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Fdg Pet ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Inhibitor Therapy ◽  
Prediction Of Response ◽  
Pet Ct ◽  
Checkpoint Inhibitor Therapy ◽  
18F Fdg ◽  
Fdg Pet Ct

ATL: Does Metabolic Response Predicts Survival?

2014 ◽  
Vol 24 (2) ◽  
pp. 312-320 ◽  
Author(s):  
Varun Singh Dhull ◽  
Punit Sharma ◽  
Daya Nand Sharma ◽  
Sagar Maharjan ◽  
Sudhir Suman KC ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Metabolic Response ◽  
Progression Free Survival ◽  
Response Evaluation ◽  
Carcinoma Cervix ◽  
Free Survival ◽  
Treatment Response Evaluation ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

PurposeThis study aimed to assess the role of18F-fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET-CT) in response assessment of patients with recurrent carcinoma cervix and in evaluating the predictive value of metabolic response for progression-free survival (PFS) and overall survival (OS).MethodsThirty-six patients with histopathologically or clinically evident recurrent cervical carcinoma underwent a pretherapy and a posttherapy18F-FDG PET-CT for treatment response evaluation. Positron emission tomography–CT images were analyzed by 2 experienced nuclear medicine physicians. Response was categorized using European Organization for Research and Treatment of Cancer (EORTC) criteria into complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD). Clinical/imaging follow-up (minimum of 6 months) and/or histopathologic findings were taken as reference standard. Patients were categorized into 2 groups, those with PMD and those without PMD (ie, CMR, PMR, and SMD). Progression-free survival and OS based on PET-CT response were measured from the date of posttherapy PET-CT to the first documentation of progression of disease and death, respectively.ResultsOn the basis of metabolic response on posttherapy PET-CT, 6 patients had CMR, 12 patients had PMR, 7 patients had SMD, and 11 patients had PMD. Progression-free survival for patients with cervical carcinoma ranged from 0.5 to 26.5 months (mean [SD], 6.7 [6.1] months). Median PFS for patients with PMD was 3.1 months, whereas median PFS for those without PMD was not reached. Patients who did not show PMD on posttherapy PET-CT had a significantly better PFS than those patients who showed PMD (P< 0.0001; HR, 0.14). There was no statistically significant difference in OS between the 2 groups (P= 0.187; HR, 0.39).Conclusions18F-fluorodeoxyglucose PET-CT is an effective tool for treatment response evaluation in recurrent carcinoma cervix. Patients with metabolically progressive disease on posttherapy18F-FDG PET-CT have a significantly shorter PFS.

scholarly journals Interim [18F]FDG PET/CT can predict response to anti-PD-1 treatment in metastatic melanoma

2020 ◽  
Author(s):  
Christos Sachpekidis ◽  
Annette Kopp-Schneider ◽  
Leyun Pan ◽  
Dimitrios Papamichail ◽  
Uwe Haberkorn ◽  
...  
Keyword(s):  
Metabolic Disease ◽  
Metastatic Melanoma ◽  
Fdg Pet ◽  
Metabolic Response ◽  
European Organization ◽  
Interim Pet ◽  
Pet Ct ◽  
Eortc Criteria ◽  
Significant Difference ◽  
Fdg Pet Ct

Abstract Purpose In an attempt to identify biomarkers that can reliably predict long-term outcomes to immunotherapy in metastatic melanoma, we investigated the prognostic role of [18F]FDG PET/CT, performed at baseline and early during the course of anti-PD-1 treatment. Methods Twenty-five patients with stage IV melanoma, scheduled for treatment with PD-1 inhibitors, were enrolled in the study (pembrolizumab, n = 8 patients; nivolumab, n = 4 patients; nivolumab/ipilimumab, 13 patients). [18F]FDG PET/CT was performed before the start of treatment (baseline PET/CT) and after the initial two cycles of PD-1 blockade administration (interim PET/CT). Seventeen patients underwent also a third PET/CT scan after administration of four cycles of treatment. Evaluation of patients’ response by means of PET/CT was performed after application of the European Organization for Research and Treatment of Cancer (EORTC) 1999 criteria and the PET Response Evaluation Criteria for IMmunoTherapy (PERCIMT). Response to treatment was classified into 4 categories: complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD). Patients were further grouped into two groups: those demonstrating metabolic benefit (MB), including patients with SMD, PMR, and CMR, and those demonstrating no MB (no-MB), including patients with PMD. Moreover, patterns of [18F]FDG uptake suggestive of radiologic immune-related adverse events (irAEs) were documented. Progression-free survival (PFS) was measured from the date of interim PET/CT until disease progression or death from any cause. Results Median follow-up from interim PET/CT was 24.2 months (19.3–41.7 months). According to the EORTC criteria, 14 patients showed MB (1 CMR, 6 PMR, and 7 SMD), while 11 patients showed no-MB (PMD). Respectively, the application of the PERCIMT criteria revealed that 19 patients had MB (1 CMR, 6 PMR, and 12 SMD), and 6 of them had no-MB (PMD). With regard to PFS, no significant difference was observed between patients with MB and no-MB on interim PET/CT according to the EORTC criteria (p = 0.088). In contrary, according to the PERCIMT criteria, patients demonstrating MB had a significantly longer PFS than those showing no-MB (p = 0.045). The emergence of radiologic irAEs (n = 11 patients) was not associated with a significant survival benefit. Regarding the sub-cohort undergoing also a third PET/CT, 14/17 patients (82%) showed concordant responses and 3/17 (18%) had a mismatch of response assessment between interim and late PET/CT. Conclusion PET/CT-based response of metastatic melanoma to PD-1 blockade after application of the recently proposed PERCIMT criteria is significantly correlated with PFS. This highlights the potential ability of [18F]FDG PET/CT for early stratification of response to anti-PD-1 agents, a finding with possible significant clinical and financial implications. Further studies including larger numbers of patients are necessary to validate these results.

Role of FDG-PET/CT in stage 1–4 malignant melanoma patients

2016 ◽  
Vol 40 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Mai Eldon ◽  
Ulrik Knap Kjerkegaard ◽  
Mette Heisz Ørndrup ◽  
Pia Sjøgren ◽  
Lars Bjørn Stolle
Keyword(s):  
Malignant Melanoma ◽  
Fdg Pet ◽  
Pet Ct ◽  
Melanoma Patients ◽  
Fdg Pet Ct ◽  
Stage 1

scholarly journals Dual time point imaging fluorine-18 flourodeoxyglucose positron emission tomography for evaluation of large loco-regional recurrences of breast cancer treated with electrochemotherapy

2013 ◽  
Vol 47 (4) ◽  
pp. 358-365 ◽  
Author(s):  
Louise Wichmann Matthiessen ◽  
Helle Hjorth Johannesen ◽  
Kristin Skougaard ◽  
Julie Gehl ◽  
Helle Westergren Hendel
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Post Injection ◽  
Response Evaluation ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Uptake Pattern ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background. Electrochemotherapy is a local anticancer treatment very efficient for treatment of small cutaneous metastases. The method is now being investigated for large cutaneous recurrences of breast cancer that are often confluent masses of malignant tumour with various degrees of inflammation. To this end 18-Flourine- Flourodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could be a method for response evaluation. However, a standard FDG-PET/CT scan cannot differentiate inflammatory tissue from malignant tissue. Dual point time imaging (DTPI) FDG-PET has the potential of doing so. The purpose of this study was to investigate if DTPI FDG-PET/CT could assess response to electrochemotherapy and to assess the optimal timing of imaging. Patients and methods. Within a phase II clinical trial 11 patients with cutaneous recurrences had FDG-PET/CT scans at three time points: 60 min, 120 min and 180 min after FDG injection. The scans were performed before and 3 weeks after electrochemotherapy. Results. A significant reduction in maximum standard uptake value at 60 min post injection was seen after treatment. Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment. The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease. To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal. Conclusions. The present study shows that FDG-PET/CT 60 and 180 min after tracer injection is a promising tool for response evaluation of cutaneous recurrences of breast cancer treated with electrochemotherapy.

Sign in / Sign up

Export Citation Format

Share Document