A New Reliable SUV Index for Evaluating Local Control Using F-18 FDG PET Following Lung SBRT

Background and Purpose. The accurate prediction of prognosis and pattern of failure is crucial for optimizing treatment strategies for patients with cancer, and early evidence suggests that image texture analysis has great potential in predicting outcome both in terms of local control and treatment toxicity. The aim of this study was to assess the value of pretreatment 18F-FDG PET texture analysis for the prediction of treatment failure in primary head and neck squamous cell carcinoma (HNSCC) treated with concurrent chemoradiation therapy. Methods. We performed a retrospective analysis of 90 patients diagnosed with primary HNSCC treated between January 2010 and June 2017 with concurrent chemo-radiotherapy. All patients underwent 18F-FDG PET/CT before treatment. 18F-FDG PET/CT texture features of the whole primary tumor were measured using an open-source texture analysis package. Least absolute shrinkage and selection operator (LASSO) was employed to select the features that are associated the most with clinical outcome, as progression-free survival and overall survival. We performed a univariate and multivariate analysis between all the relevant texture parameters and local failure, adjusting for age, sex, smoking, primary tumor site, and primary tumor stage. Harrell c-index was employed to score the predictive power of the multivariate cox regression models. Results. Twenty patients (22.2%) developed local failure, whereas the remaining 70 (77.8%) achieved durable local control. Multivariate analysis revealed that one feature, defined as low-intensity long-run emphasis (LILRE), was a significant predictor of outcome regardless of clinical variables (hazard ratio < 0.001, P=0.001).The multivariate model based on imaging biomarkers resulted superior in predicting local failure with a c-index of 0.76 against 0.65 of the model based on clinical variables alone. Conclusion. LILRE, evaluated on pretreatment 18F-FDG PET/CT, is associated with higher local failure in patients with HNSCC treated with chemoradiotherapy. Using texture analysis in addition to clinical variables may be useful in predicting local control.

Download Full-text

The Importance of Concurrent Chemotherapy for T1 Esophageal Cancer: Role of FDG-PET/CT for Local Control

In Vivo ◽

10.21873/invivo.11376 ◽

2018 ◽

Vol 32 (5) ◽

pp. 1269-1274 ◽

Cited By ~ 2

Author(s):

ICHIRO OGINO ◽

SHIGENOBU WATANABE ◽

KINGO HIRASAWA ◽

TOSHIHORO MISUMI ◽

MASAHARU HATA ◽

...

Keyword(s):

Esophageal Cancer ◽

Local Control ◽

Fdg Pet ◽

Concurrent Chemotherapy ◽

Pet Ct ◽

Fdg Pet Ct

Download Full-text

P1.17-03 Inter-Fraction Variability of 18-FDG PET During Lung SBRT and the Effect of Systemic and Immunotherapy: Results of a Prospective Pilot Study

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.1277 ◽

2019 ◽

Vol 14 (10) ◽

pp. S607-S608

Author(s):

S. Tian ◽

J. Switchenko ◽

I. Sethi ◽

X. Yang ◽

A. Da Silva ◽

...

Keyword(s):

Pilot Study ◽

Fdg Pet ◽

Prospective Pilot Study ◽

Lung Sbrt

Download Full-text

FDG-PET based dose escalated adjuvant tomotherapy (image-guided intensity-modulated radiotherapy) utilizing 4D-CT planning for high-risk adrenocortical carcinoma (ACC): A case study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e13522 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e13522-e13522

Author(s):

Ujjal Mallick ◽

S Ramamurty ◽

Ruth Elizabeth Carr ◽

Nick Willis ◽

S Ball ◽

...

Keyword(s):

High Risk ◽

Local Control ◽

Dose Escalation ◽

Adrenocortical Carcinoma ◽

Fdg Pet ◽

Adjuvant Radiotherapy ◽

Target Volume ◽

Proliferation Index ◽

4D Ct ◽

Integrated Boost

e13522 Background: ACC is a rare endocrine malignancy with an annual incidence of 0.5-2/million/year. Surgery is the mainstay of treatment but relapse rate is high and the prognosis is dismal (20-50% 5 year survival). Adjuvant Radiotherapy improves local control in cases with high risk of local failure and dose escalation may achieve better results. Dose Escalation with 3-Dimensional computed tomography (CT) based radiotherapy is difficult for ACC due to unacceptable toxicity to several adjacent organs at risk (OARs) e.g., the kidneys, stomach bowel, liver, spinal cord. FDG-PET helps delineation of areas of higher metabolic activity and density of clonogenic cells within the target (Biological Target Volume or BTV) where focal dose escalation could be directed safely for improving local control as in other solid tumours. Tomotherapy (IMRT with daily image guidance) delivers precision radiotherapy with integrated boost to the BTV, lower dose to OARs, improved coverage of the targets, and better dose delivery across the targets which are essential for tumour control. 4-Dimensional CT for planning allows adequate Clinical Target Volume(CTV) coverage despite respiratory movements. Methods: A 63 year old lady had left adrenalectomy for an adrenocortical carcinoma measuring 29 x 18 x 25mm (TNM pT1NXMX) thought to be microscopically incompletely excised (R1) with a proliferation index ( Ki-67) of 40% for which adjuvant radiotherapy was advised. PET-CT, 4D-CT and Tomotherapy were used for planning. A total dose of 50.4Gy to PTV with a simultaneous integrated boost to BTV taking it up to 59.40Gy (1.98Gy/ fraction) in 30 daily fractions was prescribed. Results: Target dose and coverage were very satisfactory. The doses to OARs were well within tolerance despite dose escalation; she completed treatment with only grade- fatigue. She had metastatic disease at 11 months follow-up without local relapse. Conclusions: To our knowledge this is the first report of using FDG –PET based dose escalation, 4D CT and Tomotherapy in high risk ACC to improve local control and needs further study.

Download Full-text

EP-1255: SABR and FDG-PET in lung cancer: a SUV cut-off value before treatment to predict local control.

Radiotherapy and Oncology ◽

10.1016/s0167-8140(16)32505-1 ◽

2016 ◽

Vol 119 ◽

pp. S593

Author(s):

S. Vagge ◽

M. Marcenaro ◽

G. Timon ◽

G. Siffredi ◽

R. Corvò

Keyword(s):

Lung Cancer ◽

Local Control ◽

Fdg Pet

Download Full-text

Residual 18F-FDG-PET Uptake 12 Weeks After Stereotactic Ablative Radiotherapy for Stage I Non-Small-Cell Lung Cancer Predicts Local Control

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2012.01.012 ◽

2012 ◽

Vol 83 (4) ◽

pp. e551-e555 ◽

Cited By ~ 59

Author(s):

Vikram Rao Bollineni ◽

Joachim Widder ◽

Jan Pruim ◽

Johannes A. Langendijk ◽

Erwin M. Wiegman

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Local Control ◽

Cell Lung Cancer ◽

Fdg Pet ◽

Small Cell ◽

Stage I ◽

Stereotactic Ablative Radiotherapy ◽

Small Cell Lung ◽

18F Fdg

Download Full-text

FDG-PET Predicts Pain Response and Local Control in Palliative Radiotherapy With or Without Systemic Treatment in Patients With Bone Metastasis From Non–small-cell Lung Cancer

Clinical Lung Cancer ◽

10.1016/j.cllc.2015.01.005 ◽

2015 ◽

Vol 16 (6) ◽

pp. e111-e119 ◽

Cited By ~ 12

Author(s):

Fen Zhao ◽

Gang Ding ◽

Wei Huang ◽

Minghuan Li ◽

Zheng Fu ◽

...

Keyword(s):

Lung Cancer ◽

Bone Metastasis ◽

Small Cell Lung Cancer ◽

Local Control ◽

Fdg Pet ◽

Systemic Treatment ◽

Palliative Radiotherapy ◽

Small Cell ◽

Pain Response ◽

Small Cell Lung

Download Full-text

Assessment of local control after laser-induced thermotherapy of liver metastases from colorectal cancer: contribution of FDG-PET in patients with clinical suspicion of progressive disease

Acta Radiologica ◽

10.1080/02841850701545771 ◽

2007 ◽

Vol 48 (8) ◽

pp. 821-830 ◽

Cited By ~ 14

Author(s):

T. Denecke ◽

I. Steffen ◽

B. Hildebrandt ◽

R. Rühl ◽

F. Streitparth ◽

...

Keyword(s):

Liver Metastases ◽

Tumor Progression ◽

Local Control ◽

Fdg Pet ◽

Colorectal Liver Metastases ◽

Progressive Disease ◽

Systemic Disease ◽

Clinical Suspicion ◽

Whole Body ◽

Promising Alternative

Background: Management of patients after locally ablative treatment of liver metastases requires exact information about local control and systemic disease status. To fulfill these requirements, whole-body imaging using positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) is a promising alternative to morphologic imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Purpose: To evaluate FDG-PET for the assessment of local control and systemic disease in patients with clinical suspicion of tumor progression after laser-induced thermotherapy (LITT) of colorectal liver metastases. Material and Methods: In 21 patients with suspicion of progressive disease after LITT, whole-body FDG-PET was performed. The presence of viable tumor within treated lesions, new liver metastases, and extrahepatic disease was evaluated visually and semiquantitatively (maximal standard uptake value [SUVmax], tumor-to-normal ratio [T/N]). The standard of reference was histopathology ( n = 25 lesions) and/or clinical follow-up (>12 months) including contrast-enhanced MRI of the liver. Results: Among 54 metastases treated with LITT, 29 had residual tumor. Receiver operating characteristic (ROC) analysis of SUVmax (area under the curve (AUC) 0.990) and T/N (AUC 0.968) showed a significant discrimination level of negative or positive lesion status with an equal accuracy of 94% (51/54). The overall accuracy of visual FDG-PET was 96% (52/54), with one false-negative lesion among six examined within 3 days after LITT, and one false-positive lesion examined 54 days after LITT. In the detection of new intra- and extrahepatic lesions, FDG-PET resulted in correct alteration of treatment strategy in 43% of patients ( P = 0.007). Conclusion: FDG-PET is a promising tool for the assessment of local control and whole-body restaging in patients with clinical suspicion of tumor progression after locally ablative treatment of colorectal liver metastases with LITT.

Download Full-text