Dual-Energy CT-Based Iodine Quantitation for Response Evaluation of Lung Cancers to Chemoradiation Therapy/Radiation Therapy: A Comparison with 18 FDG–PET/CT-Based PERCIST

Summary Introduction: The standard treatment for locally advanced rectal cancer (RC) consists of neoadjuvant chemoradiation followed by radical surgery. Regardless the extensive use of SUVmax in 18F-FDG PET tumor uptake as representation of tumor glycolytic consumption, there is a trend to apply metabolic volume instead. Thus, the aim of the present study was to evaluate a noninvasive method for tumor segmentation using the 18F-FDG PET imaging in order to predict response to neoadjuvant chemoradiation therapy in patients with rectal cancer. Method: The sample consisted of stage II and III rectal cancer patients undergoing 18F-FDG PET/CT examination before and eight weeks after neoadjuvant therapy. An individualized tumor segmentation methodology was applied to generate tumor volumes (SUV2SD) and compare with standard SUVmax and fixed threshold (SUV40%, SUV50% and SUV60%) pre- and post-therapy. Therapeutic response was assessed in the resected specimens using Dworak's protocol recommendations. Several variables were generated and compared with the histopathological results. Results: Seventeen (17) patients were included and analyzed. Significant differences were observed between responders (Dworak 3 and 4) and non-responders for SUVmax-2 (p<0.01), SUV2SD-2 (p<0.05), SUV40%-2 (p<0.05), SUV50%-2 (p<0.05) and SUV60%-2 (p<0.05). ROC analyses showed significant areas under the curve (p<0.01) for the proposed methodology with sensitivity and specificity varying from 60% to 83% and 73% to 82%, respectively. Conclusion: The present study confirmed the predictive power of the variables using a noninvasive individualized methodology for tumor segmentation based on 18F-FDG PET/CT imaging for response evaluation in patients with rectal cancer after neoadjuvant chemoradiation therapy.

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Clinical utility of dual-energy CT used as an add-on to 18F FDG PET/CT in the preoperative staging of resectable NSCLC with suspected single osteolytic metastases

Lung Cancer ◽

10.1016/j.lungcan.2019.10.032 ◽

2020 ◽

Vol 140 ◽

pp. 80-86 ◽

Cited By ~ 2

Author(s):

Haijun Wu ◽

Song Dong ◽

Xiuhui Li ◽

Lei Shi ◽

Dan Shao ◽

...

Keyword(s):

Fdg Pet ◽

Clinical Utility ◽

Preoperative Staging ◽

Dual Energy ◽

Dual Energy Ct ◽

Pet Ct ◽

Osteolytic Metastases ◽

18F Fdg ◽

Fdg Pet Ct

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Single-source Dual-energy CT as a Part of 18F-FDG PET/CT: Direct Comparison of Iodine-related and Metabolic Parameters in Non-small Cell Lung Cancer

Anticancer Research ◽

10.21873/anticanres.12704 ◽

2018 ◽

Vol 38 (7) ◽

pp. 4131-4137

Author(s):

JAN BAXA ◽

TANA MATOUSKOVA ◽

JAROSLAV LUDVIK ◽

MARTIN SEDLMAIR ◽

THOMAS FLOHR ◽

...

Keyword(s):

Lung Cancer ◽

Fdg Pet ◽

Dual Energy ◽

Small Cell ◽

Dual Energy Ct ◽

Single Source ◽

Small Cell Lung ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Enhancing 18F-FDG-PET/CT analysis in lung cancer patients

Nuklearmedizin ◽

10.3413/nukmed-0763-15-08 ◽

2015 ◽

Vol 54 (06) ◽

pp. 247-254 ◽

Cited By ~ 1

Author(s):

A. Kapfhammer ◽

T. Winkens ◽

T. Lesser ◽

A. Reissig ◽

M. Steinert ◽

...

Keyword(s):

Lung Cancer ◽

Image Fusion ◽

Chest Wall ◽

Fdg Pet ◽

Ct Image ◽

Lung Cancers ◽

Pet Ct ◽

Peripheral Lung ◽

Fdg Pet Ct ◽

Tumour Infiltration

SummaryAim: To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/ CT for lung cancer staging. Methods: Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semitransparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Results: Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. Conclusion: This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

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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

Japanese Journal of Radiology ◽

10.1007/s11604-021-01174-w ◽

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.

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