scholarly journals The role of FDG PET/CT or PET/MRI in assessing response to neoadjuvant therapy for patients with borderline or resectable pancreatic cancer: a systematic literature review

2021 ◽  
Author(s):  
Laura Evangelista ◽  
Pietro Zucchetta ◽  
Lucia Moletta ◽  
Simone Serafini ◽  
Gianluca Cassarino ◽  
...  
Keyword(s):  
Neoadjuvant Therapy ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Ductal Adenocarcinoma ◽  
Resectable Pancreatic Cancer ◽  
Number Of Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractThe aim of the present systematic review is to examine the role of fluorodeoxyglucose (FDG) positron emission tomography (PET) associated with computed tomography (CT) or magnetic resonance imaging (MRI) in assessing response to preoperative chemotherapy or chemoradiotherapy (CRT) for patients with borderline and resectable pancreatic ductal adenocarcinoma (PDAC). Three researchers ran a database query in PubMed, Web of Science and EMBASE. The total number of patients considered was 488. The most often used parameters of response to therapy were the reductions in the maximum standardized uptake value (SUVmax) or the peak standardized uptake lean mass (SULpeak). Patients whose SUVs were higher at the baseline (before CRT) were associated with a better response to therapy and a better overall survival. SUVs remaining high after neoadjuvant therapy correlated with a poor prognosis. Available data indicate that FDG PET/CT or PET/MRI can be useful for predicting and assessing response to CRT in patients with resectable or borderline PDAC.

scholarly journals PET/CT and the Response to Immunotherapy in Lung Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Laura Evangelista ◽  
Matteo Sepulcri ◽  
Giulia Pasello
Keyword(s):  
Lung Cancer ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Response To Therapy ◽  
Prediction Of Response ◽  
Lung Cancer Patients ◽  
Pet Ct ◽  
Fdg Pet Ct

Objective: In recent years, the introduction of immune checkpoint inhibitors has significantly changed the outcome of patients affected by lung cancer and cutaneous melanoma. Although the clinical advantages, the selection of patients and the evaluation of response to immunotherapy remain unclear, the immune-related Response Evaluation Criteria in Solid Tumor (irRECIST) was proposed as an update of the RECIST criteria for the assessment of response to immunotherapy. However, morphological images cannot predict early response to therapy that represents a challenge in clinical practice. 18F-FDG PET/CT before and after immunotherapy has an indeterminate role, demonstrating ambiguous results due to inflammatory effects secondary to activation of the immune system. The aim of the present review was to analyze the role of PET/CT as a guide for immunotherapy, by analyzing the current status and future perspectives. Methods: A literature search was conducted in order to select all papers that discussed the role of PET/CT with FDG or other tracers in the evaluation or prediction of response to immunotherapy in lung cancer patients. Results: Many papers are now available. Many clinical trials have demonstrated the efficacy of immunotherapy in lung cancer patients. FDG PET/CT can be used for the prediction of response to immunotherapy, while its utility for the evaluation of response is not still clearly reported. Moreover, the standardization of FDG PET/CT interpretation is missing and different criteria, such as information, have been investigated until now. Conclusions: The utility of FDG PET/CT for patients with lung cancer undergoing immunotherapies is still preliminary and not well addressed. New agents for PET are promising, but large clinical trials are mandatory.

The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma

2017 ◽  
Vol 43 (2) ◽  
pp. 415-434 ◽  
Author(s):  
Randy Yeh ◽  
Laurent Dercle ◽  
Ishan Garg ◽  
Zhen Jane Wang ◽  
David M. Hough ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Fdg Pet ◽  
Ductal Adenocarcinoma ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Prognostic value of the maximum standardized uptake value of pre-treatment primary lesions in small-cell lung cancer on 18F-FDG PET/CT: a meta-analysis

2017 ◽  
Vol 59 (9) ◽  
pp. 1082-1090 ◽  
Author(s):  
Dongyong Zhu ◽  
Yanfang Wang ◽  
Lisha Wang ◽  
Jie Chen ◽  
Sama Byanju ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Meta Analysis ◽  
Standardized Uptake Value ◽  
Small Cell Lung ◽  
Prognostic Role ◽  
Pet Ct ◽  
18F Fdg ◽  
Pre Treatment ◽  
Fdg Pet Ct

Background 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) has been widely used in clinical practice. However, the prognostic value of the pre-treatment standardized uptake value (SUV) for patients with small-cell lung cancer (SCLC) remains controversial. Purpose To investigate the prognostic role of pre-treatment 18F-FDG PET on SCLC patients by meta-analysis. Material and Methods Extensive literature searches of the PubMed, EMBASE, Web of Science, and Cochrane Library databases were conducted to identify literature published until 5 May 2017. Comparative analyses of the pooled hazard ratios (HRs) for event-free survival (EFS) and overall survival (OS) were performed to assess their correlations with the pre-treatment maximum SUV (SUVmax). Either the fixed- or the random-effects model was adopted, depending on the heterogeneity observed across the studies. Subgroup analyses were performed to assess the robustness of the results. Results Twelve studies with 1062 patients were included. The pooled HR for OS of 11 studies was 1.13 (95% confidence interval [CI] = 1.05–1.22; P = 0.001; I2 = 0%) and the pooled HR for EFS of nine studies was 1.09 (95% CI = 1.02–1.17; P = 0.014; I2 = 0%), indicating that patients with high SUVs may have poorer prognoses. Begg’s test detected no significant publication bias. The prognostic role of the SUVmax remained similar in the subgroup analyses. Conclusion Our meta-analysis indicated that the pre-treatment SUVmax of primary lesions can be an important prognostic factor for OS and EFS in patients with SCLC. A high SUVmax may indicate poorer prognosis.

64Cu-DOTA-trastuzumab PET/CT to predict response to ado-trastuzumab emtansine (TDM1) in HER2-positive metastatic breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12525-e12525
Author(s):  
Joanne E. Mortimer ◽  
James R. Bading ◽  
Paul Henry Frankel ◽  
Rita Gidwaney ◽  
John Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Her2 Positive ◽  
Her2 Breast Cancer ◽  
Pet Ct ◽  
Fdg Pet Ct

e12525 Background: Having demonstrated that 64Cu-DOTA trastuzumab is an effective PET imaging agent for HER2 positive (HER2+) breast cancer, we now evaluate the methodology for prediction of response and benefit from TDM1 in women with metastatic disease. Methods: Patients eligible to receive TDM1 as therapy were chosen on the basis of biopsy confirmed HER2+ disease, and at least 1 site of metastasis ≥ 2.0 cm outside the biopsy site. Pretreatment staging included 18F-FDG PET/CT. Prior to injection of 64Cu-DOTA-trastuzumab, patients received 45 mg of cold trastuzumab to reduce liver uptake. PET-CT scans were obtained at 16-28 h (Day1) and 39-49 h (Day 2) over fields of view chosen in reference to the 18F-FDG scans. TDM1 (3.6 mg/kg) was administered every 3 weeks. Restaging 18F-FDG PET/CT was performed every 2 cycles, and response to therapy was determined by PERCIST (solid tumor) criteria. Radiolabel uptake was measured in terms of maximum voxel, standardized uptake value (SUVmax). Results: Ten women between the ages of 48-83 years old (median 55 years) qualified for study, and have been evaluated for response; 4 continue on TDM1 with treatment durations of 3-27 months.Three were trastuzumab-naïve, while 7 had received trastuzumab-containing chemotherapy 3 wks to 55 mo prior to study entry. HER2 was positive by ImmunoHistoChemistry, IHC (3+) in 5 patients, and by FISH testing in the other 5 (3 were 2+ by IHC; 1 was 1+, and 1 was indeterminate). Complete or partial metabolic response was observed in 5 patients. Median Day 2 SUVmax for 64Cu-DOTA trastuzumab was 9.3 g/ml in responding patients, and 4.6 g/ml in non-responders ( P= 0.03). Progression-free survival was longer for patients with higher SUVmax, with a hazard ratio of 0.73 (95% confidence interval 0.46-1.16) for each 1 unit increase in SUVmax. This was not statistically significant, although we can select a threshold SUVmaxfor which the effect is significant even for this small study. Further data is required to confirm such a threshold effect. Conclusions: 64Cu-DOTA-trastuzumab PET imaging predicts benefit from TDM1 in women with biopsy-confirmed HER2+ metastatic disease. Supported by NCI Clinical trial information: NCT02827877.

Functional role of 18F-FDG PET/CT imaging in pancreatic ductal adenocarcinoma patients with diabetes

Pancreatology ◽  
2013 ◽  
Vol 13 (4) ◽  
pp. S48
Author(s):  
Kwang Hyun Chung ◽  
Sang Hyub Lee ◽  
Joo Kyung Park ◽  
Jin-Hyeok Hwang
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Fdg Pet ◽  
Functional Role ◽  
Ct Imaging ◽  
Ductal Adenocarcinoma ◽  
Pet Ct ◽  
Patients With Diabetes ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Disease activity and response to therapy monitored by [18F]FDG PET/CT using volume-based indices in IgG4-related disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Katsuya Mitamura ◽  
Hanae Arai-Okuda ◽  
Yuka Yamamoto ◽  
Takashi Norikane ◽  
Yasukage Takami ◽  
...  
Keyword(s):  
Disease Activity ◽  
Fdg Pet ◽  
Interleukin 2 ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Pet Ct ◽  
Serum Igg4 ◽  
Fdg Pet Ct

Abstract Purpose The efficiency of [18F]FDG PET/CT using volume-based indices was evaluated to assess the disease activity and response to therapy in patients with immunoglobulin G4-related disease (IgG4-RD). Methods A total of 17 patients with IgG4-RD were examined with [18F]FDG PET/CT before and during treatment. The lesion boundary was determined using a fixed threshold of standardized uptake value (SUV) ≥ 2.5. The highest maximum SUV (SUVmax) among all affected lesions was calculated for individual patients. We summed metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of each affected lesion to generate a total MTV and total TLG. PET results were compared with those of serum IgG4 and soluble interleukin-2 receptor (sIL-2R) levels. Results The mean number of involved organs per patient was 3.8 as determined by [18F]FDG uptake. The number of involved organs, total MTV and total TLG were significantly correlated with IgG4 (P = 0.046, < 0.001, < 0.001, respectively) and sIL-2R (P < 0.001, = 0.031, 0.031, respectively). According to the clinical assessments for therapy response, all patients were classified as improved. The SUVmax, total MTV, and total TLG during therapy were all significantly lower than those before therapy (all P < 0.001). Conclusion [18F]FDG PET/CT is valuable for assessing the extent of multi-organ involvement before therapy and monitoring subsequent therapy in patients with IgG4-RD. [18F]FDG PET/CT using volumetric indices correlated with serum IgG4 and sIL-2R levels.

scholarly journals The role of functional imaging; DWI, ADC and 18F-FDG PET/CT in the evaluation of HCC treatment response after transarterial chemoembolization

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed S. Abdelrahman ◽  
Amgad S. Abdel-Rahman ◽  
Noha M. Taha
Keyword(s):  
Functional Imaging ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Diagnostic Value ◽  
Liver Imaging ◽  
Positron Emission ◽  
Pet Ct ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

Abstract Background The transcatheter arterial chemoembolization (TACE) is one of the treatment lines for patients with hepatocellular carcinoma (HCC), this study was conducted to assess the role of functional imaging including the DWI, ADC and 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) for detection of residual HCC after TACE as compared to the structural liver imaging reporting and data system (LI-RADS). Results The optimal cut off value of standardized uptake value ratio (SUVmax/liver SUVmean ratio) for detection of residual viable HCC after TACE was 1.09 with 88.9%, 87.5% and 88.6% sensitivity, specificity, and accuracy respectively, a lower diagnostic value was noted in the qualitative visual FDG PET/CT assessment with sensitivity, specificity, and accuracy of 81.5%, 75% and 80% respectively. The sensitivity, specificity, and accuracy of DWI for identification of post-TACE viable HCC were 77.8%, 75%, and 77.1% respectively. The optimal cut off value of ADC for the diagnosis of variable HCC was 1.32 × 10−3 mm2/s with sensitivity, specificity, and accuracy of 81.5%, 75%, and 80% respectively. Conclusions DWI, ADC and FDG PET/CT are effective functional imaging modalities for the evaluation of viable residual HCC post-TACE with comparable findings for the dynamic cross-section imaging.

scholarly journals The Role of the Metabolic Parameters of 18F-FDG PET/CT in Patients With Locally Advanced Cervical Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Dunhuang Wang ◽  
Xiaoliang Liu ◽  
Weiping Wang ◽  
Li Huo ◽  
Qingqing Pan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Fdg Pet ◽  
Locally Advanced ◽  
Standardized Uptake Value ◽  
Metabolic Parameters ◽  
Free Survival ◽  
Pet Ct ◽  
Pre Treatment ◽  
Fdg Pet Ct

PurposeTo evaluate the role of the pre-treatment cervical and lymph node (LN) metabolic parameters of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) for locally advanced cervical cancer (LACC) patients receiving concurrent chemoradiotherapy or radiotherapy.Methodswe reviewed 125 consecutive patients with LACC who underwent pre-treatment 18F-FDG PET/CT examination and concurrent chemoradiotherapy or radiotherapy from February 2010 to December 2015 at our institute. The mean standardized uptake value (SUVmean), maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of cervical lesion and lymph node (LN) were recorded. Receiver operator characteristic curve, C-index, Kaplan-Meier method, and Cox proportional hazards models were performed.ResultsThe median follow-up was 62 months (range, 4-114 months). For 125 included patients with cervical cancer, the 5-year overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastasis-free survival (DMFS) rates were 83.6%, 75.1%, 92.3% and 79.9%, respectively. Cervical MTV (c-index 0.59-0.61) and cervical TLG (c-index 0.60-0.62) values calculated with a threshold of 40% SUVmax presented stronger prediction capability than cervical SUVmean (c-index 0.51-0.58) and cervical SUVmax (c-index 0.53-0.57) for OS, DFS, LC, and DMFS. In univariate analysis, cervical TLG ≥ 113.4 had worse DFS and DMFS. Cervical MTV ≥ 18.3 cm3 had worse OS and DMFS. In multivariate analysis, cervical TLG ≥ 113.4 implied worse OS, DFS, and DMFS. In either univariate or multivariate analyses, cervical SUVmean and cervical SUVmax had no statistically significant correlation with OS, DFS, LC and DMFS. For 55 cervical cancer patients with positive LN, LN SUVmax presented strongest prediction capability for OS (c-index = 0.79), DFS (c-index = 0.72), LC (c-index = 0.62), and DMFS (c-index = 0.79). In multivariate analysis, LN SUVmax remained significant biomarker linked to OS, DFS, and DMFS.ConclusionPre-treatment cervical and LN metabolic parameters were associated with survival outcomes in patients with LACC. In our study, we found that pre-treatment cervical TLG and LN SUVmax may be important prognostic biomarkers for OS, DFS, and DMFS. However, further prospective studies with a large number of patients are required to evaluate the value of the metabolic parameters in survival outcomes prediction.

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