The Impact of PET/CT Scan in Treatment Decision and External Beam Field Design in the Management of Cervical Cancer

e20014 Background: Correct staging of small cell lung cancer (SCLC) in limited disease (LD) or extensive disease (ED) is crucial as it has an impact on the therapeutic decision-making. The staging procedures in SCLC in the late 1990s included chest X-ray, blood samples, abdominal ultrasonography (UL), and iliac crest BMex. The aim of this study was to evaluate the continued eligibility of performing BMex in patients (ptt) with SCLC as a routine staging procedure, and to see how often therapeutic decisions were influenced by a positive BM before and after the PET/CT scan era. Methods: All diagnostic and staging procedures were registered in ptt with SCLC referred to our department from 1995 to 1999 in cohort 1 (C1). Cohort 2 (C2) included SCLC patients referred from 2009 to 2013. In C2 results of PET/CT in terms of bone metastases were related to results of BMex. Results: In C1 194 ptt was referred with 136 (70%) having ED. BMex was omitted in 32 (17%) fragile ptt having known ED while all LD ptt underwent BMex. BM involvement was seen in 37 (23%) of all 162 BMex and 36% of the 104 ED ptt examined. When BM was negative the staging of ED was due to other imaging. The BM had an impact on therapeutic decision-making in 5 (4%) of 136 having ED and 5 (3%) of 162 BMex. In C2 211 ptt of 292 (72%) had ED and 203 (70%) of all ptt underwent BMex. BM biopsy was done in 137 (65 %) ED and in 66 (69 %) LD. Of 137 ED ptt BM involvement was found in 31 (23 %) cases. A PET/CT scan was performed in 13 (42 %) of these ptt of which bone metastases was found in 12 (92 %). One patient (8%) had a PET/CT without bone lesions. Bone metastases were seen at PET/CT scan in 61 ptt in C2, of these 22 (36%) had negative BM, whereas 12 (20%) had BM involvement and in 3 ptt (5%) BMex were inconclusive. No BMex was performed in 24 ptt (39%). BMex had an impact on therapeutic decision-making in 3 (1.4%) of 211 having ED and 5 (2.5%) of 203 BMex. Conclusions: Due to staging by PET/CT and CT scan in SCLC ptt the impact of BMex in the therapeutic decision-making has decreased and fewer ptt are undergoing BMex. Though a negative PET/CT cannot exclude BM involvement BMex may be considered omitted.

Download Full-text

Characterization of surgically transposed ovaries in integrated PET/CT scan in patients with cervical cancer

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1080/00016340601033626 ◽

2007 ◽

Vol 86 (1) ◽

pp. 88-93 ◽

Cited By ~ 7

Author(s):

Hyun Hoon Chung ◽

Won Jun Kang ◽

Jae Weon Kim ◽

Noh-Hyun Park ◽

Yong-Sang Song ◽

...

Keyword(s):

Cervical Cancer ◽

Ct Scan ◽

Pet Ct ◽

Pet Ct Scan

Download Full-text

Letter to editor regarding Urban et al., FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status

Radiotherapy and Oncology ◽

10.1016/j.radonc.2020.06.032 ◽

2020 ◽

Vol 150 ◽

pp. 150

Author(s):

Robert Rulach ◽

Suyun Zhou ◽

Claire Paterson

Keyword(s):

Head And Neck Cancer ◽

Ct Scan ◽

Head And Neck ◽

Neck Cancer ◽

Fdg Pet ◽

Radical Radiotherapy ◽

Pet Ct ◽

Fdg Pet Ct ◽

The Impact ◽

Pet Ct Scan

Download Full-text

Prognostic impact of posttransplant FDG PET/CT scan in multiple myeloma

Blood Advances ◽

10.1182/bloodadvances.2020004131 ◽

2021 ◽

Vol 5 (13) ◽

pp. 2753-2759

Author(s):

Marcella Kaddoura ◽

David Dingli ◽

Francis K. Buadi ◽

Martha Q. Lacy ◽

Morie A. Gertz ◽

...

Keyword(s):

Multiple Myeloma ◽

Ct Scan ◽

Prognostic Significance ◽

Ct Scanning ◽

Prognostic Impact ◽

Cell Transplant ◽

Entire Cohort ◽

Pet Ct ◽

The Impact ◽

Pet Ct Scan

Abstract Multiple myeloma (MM) is a heterogeneous disease that may be evaluated by a broad array of imaging and laboratory techniques to measure disease activity and predict prognosis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning has been shown to be predictive of patient outcomes throughout the disease course. We sought to corroborate these findings by examining the prognostic impact of PET/CT scanning in the posttransplant setting. We retrospectively analyzed PET/CT scans in 229 MM patients receiving an autologous stem cell transplant (ASCT) near day 100, and correlated these findings with time to progression(TTP) and overall survival (OS) to assess the impact of day 100 PET/CT scan findings as an independent prognostic factor. The median OS for the entire cohort was 61.5 months (95% confidence interval [CI], 49-75) and the median TTP was 18.5 months (95% CI, 15.4-21.8). Among patients with abnormal day 100 PET findings (PET+), median TTP was 12.4 months vs 24 months among those with normal PET findings (PET−) (P < .0001). The median OS in the PET+ group was 46 months compared with 99 months in the PET− group (P < .0001). We conclude that an abnormal PET/CT scan near day 100 post-ASCT is predictive of shorter TTP and OS, with prognostic significance retained after adjusting for disease response and other prognostic variables in MM.

Download Full-text

Impact of the 18F- PET/CT scan in the management of patients with high-risk or intermediate-risk prostate cancer at initial diagnosis or at recurrence.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.7_suppl.87 ◽

2015 ◽

Vol 33 (7_suppl) ◽

pp. 87-87

Author(s):

Gilles Pasticier ◽

Marine Chicart ◽

Marine Gross-Goupil ◽

Laurence Donon ◽

Gregoire Robert ◽

...

Keyword(s):

Prostate Cancer ◽

Ct Scan ◽

Predictive Value ◽

Diagnostic Performance ◽

Initial Diagnosis ◽

Whole Body ◽

Pet Ct ◽

The Impact ◽

Pet Ct Scan ◽

Initial Staging

87 Background: It is reported that a Fcholine Positron Emission Tomography (PET/CT) scan can change the management of the patients with prostate cancer up to 20% of the cases. The aim of this study was to evaluate the impact of 18FCholine PET/CT when its indication was taken by a multi-disciplinary staff in case of initial diagnosis or in case of recurrence. Methods: This retrospective study involved 84 patients between May 2013 and July 2014. After a selective approach 86 18F-PET/CT were performed consecutively: 37 (43%) for the initial staging and 49 (57%) in biochemical failure. The acquisition protocol included a pelvic dynamic scan after injection of 4 MBq/kg of 18FCholine followed by a whole-body scan. Mean age, PSA level and Gleason score were respectively in relapse and initial staging: 71 years (59-82), 4.9 (0.12-32.8), 7 (6-9) and 63 years (48-76), 16 (2.42-55) and 8 (6-10). Results: In initial diagnosis, prostate cancer was identified in all the patients on PET/CT. Local disease was seen in 23/37 scans (62.2%); loco-regional node involvement in 8 (21.6%) and metastatic disease in 6 (16.2%). PET/CT confirmed the therapeutic decision in 48.6% of cases and led to a therapeutic modification in 43.2% of cases,avoiding radical prostatectomy and lymphadenectomy in 25% of cases or modifying the extend of radiotherapy (25%) . In biochemical recurrence, PET/CT showed relapse in the prostatic area in 14 patients (28.6%); abnormal pelvic lymph nodes in 10 cases (20.4%) and distant metastases in 18 patients (36.7%). It failed to identify the cause of relapse in 7 cases (14.3%). PET/CT confirmed the therapeutic approach in 24.5% and led to a therapeutic change in 61.2% of cases The diagnostic performance of the FCholine PET/CT scan on nodes, according to the pathological results were: sensitivity 80 %, specificity 84.6%, positive predictive value 66.7% and negative predictive value 91.7 % Conclusions: A rigorous selection of the patients before the realization of a FCholine PET/CT scan in the management of a prostate cancer can increase the diagnostic performance and provide a better impact. In this study the treatment modification affected 54.8% of the patients.

Download Full-text

The Impact of Hybrid PET-CT Scan on Overall Oncologic Management, with a Focus on Radiotherapy Planning: A Prospective, Blinded Study

Technology in Cancer Research & Treatment ◽

10.1177/153303460900800208 ◽

2009 ◽

Vol 8 (2) ◽

pp. 149-158 ◽

Cited By ~ 27

Author(s):

Tim J. Kruser ◽

Kristin A. Bradley ◽

Soren M. Bentzen ◽

Bethany M. Anderson ◽

Vinai Gondi ◽

...

Keyword(s):

Ct Scan ◽

Radiotherapy Planning ◽

Pet Ct ◽

Blinded Study ◽

The Impact ◽

Pet Ct Scan

Download Full-text

PB1837 THE PREDICTIVE VALUE OF PET/CT SCAN IN DIFFUSE LARGE B-CELL LYMPHOMA IN OPTIMIZING THE TREATMENT DECISION

HemaSphere ◽

10.1097/01.hs9.0000565852.22530.6f ◽

2019 ◽

Vol 3 (S1) ◽

pp. 840 ◽

Cited By ~ 1

Author(s):

H. Zawam ◽

S. Alrefai ◽

M. Abougabal ◽

R. Salama ◽

H. Zawam ◽

...

Keyword(s):

Ct Scan ◽

B Cell ◽

Predictive Value ◽

Cell Lymphoma ◽

Treatment Decision ◽

B Cell Lymphoma ◽

Large B Cell Lymphoma ◽

Pet Ct ◽

Pet Ct Scan ◽

Large B Cell

Download Full-text

The impact of varying number of OSEM iterations on Standardized Uptake Value (SUV) and image quality of PET/CT Scan

Pakistan Journal of Nuclear Medicine ◽

10.24911/pjnmed.175-1599635121 ◽

2021 ◽

pp. 1

Author(s):

Babar Ali ◽

Afshan Ashfaq ◽

Muhammad Kakakhel

Keyword(s):

Image Quality ◽

Ct Scan ◽

Standardized Uptake Value ◽

Pet Ct ◽

The Impact ◽

Pet Ct Scan

Download Full-text

FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status

Radiotherapy and Oncology ◽

10.1016/j.radonc.2020.03.032 ◽

2020 ◽

Vol 148 ◽

pp. 14-20 ◽

Cited By ~ 3

Author(s):

Ryan Urban ◽

Tassia Godoy ◽

Robert Olson ◽

Jonn Wu ◽

Eric Berthelet ◽

...

Keyword(s):

Head And Neck Cancer ◽

Ct Scan ◽

Head And Neck ◽

Neck Cancer ◽

Fdg Pet ◽

Radical Radiotherapy ◽

Pet Ct ◽

Fdg Pet Ct ◽

The Impact ◽

Pet Ct Scan

Download Full-text

Laparoscopic extraperitoneal para-aortic lymphadenectomy in patients with locally advanced cervical cancer: Histopathologic findings and correlation with PET-CT imaging studies

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.5014 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 5014-5014

Author(s):

R. L. Coleman ◽

P. T. Ramirez ◽

B. M. Slomovitz ◽

C. Levenback

Keyword(s):

Cervical Cancer ◽

Ct Scan ◽

Locally Advanced ◽

Ct Imaging ◽

Advanced Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Pet Ct ◽

Preoperative Ct ◽

Histopathologic Findings ◽

Pet Ct Scan

5014 Objective: To evaluate the safety and feasibility of laparoscopic extraperitoneal para-aortic lymphadenectomy and to correlate histopathologic findings and preoperative PET-CT imaging in patients with locally advanced cervical cancer. Methods: We performed a prospective study of patients with locally advanced cervical cancer. Patients enrolled underwent laparoscopic extraperitoneal para-aortic lymphadenectomy prior to chemoradiation at our tertiary cancer center from April 2004 to June 2005. All patients had a preoperative CT scan and PET-CT scan. Results: 12 patients were enrolled. One patient did not undergo surgery. No patient had evidence of metastatic disease to the para-aortic area by preoperative CT scan. The median age was 48 years (range, 35–67). 10 patients were diagnosed with squamous cell carcinoma, one patient with adenocarcinoma, and one patient with transitional cell carcinoma. The stage distribution was: IB2 (3), IIA (1), IIB (4), IIIA (1), IIIB (3). The median BMI was 26 (range, 18.6–29.7). Two (18%) of 11 patients had a positive preoperative PET-CT imaging study for disease in the para-aortic lymph nodes. The median time of surgery was 162 minutes (range, 52–247). The median blood loss was 25 mL (range, 10–100). There were no intraoperative complications. No patient required intraoperative blood transfusions. The median length of postoperative stay was 1 day (range, 1–2). There were two patients who developed postoperative lymphocysts requiring drainage. The median number of lymph nodes removed was 11 (range, 4–17). A total of 2 (18%) of 11 patients had evidence of histologically confirmed lymph node metastases. Of these, only one patient had evidence of disease by PET-CT scan. Only one of the two patients with a positive PET-CT scan for disease in the para-aortic nodes, actually had disease confirmed histopathologically. The sensitivity and specificity of PET-CT scan is 50% and 89%, respectively. Conclusions: Laparoscopic extraperitoneal para-aortic lymphadenectomy is safe, feasible and appears to increase the precision of identifying occult metastasis. Further patient accrual will be needed to evaluate the ultimate utility of PET-CT imaging in this setting. No significant financial relationships to disclose.

Download Full-text