scholarly journals Diagnostic and prognostic value of 99mTc-MAA SPECT/CT for treatment planning of 90Y-resin microsphere radioembolization for hepatocellular carcinoma: comparison with planar image

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mai Hong Son ◽  
Le Ngoc Ha ◽  
Mai Hong Bang ◽  
Sungwoo Bae ◽  
Dinh Truong Giang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Treatment Planning ◽  
Absorbed Dose ◽  
Post Treatment ◽  
Predictive Values ◽  
Planar Image ◽  
Image Characteristics ◽  
Pet Ct ◽  
Pre Treatment

Abstract99mTc-macroaggregated albumin (MAA) imaging is performed before transarterial radioembolization (TARE), in which SPECT/CT is presumed more precise than planar image. However, additive role of SPECT/CT has not been well established. Thirty-four consecutive hepatocellular carcinoma patients of intermediate and advanced stages who underwent 90Y-microsphere TARE were recruited. On pre-treatment planning scan using 99mTc-MAA, image characteristics and absorbed dose for target tumors calculated by partition model methods were estimated on planar image and SPECT/CT, respectively. The measurements were repeated on post-treatment 90Y PET/CT, as the reference standard. Treatment response was assessed and predictive values of image parameters were analyzed. The image characteristics including heterogeneity, necrosis and thrombosis uptake were better delineated on SPECT/CT than planar scan. The agreement and correlation of TNr between SPECT/CT and PET/CT were stronger than those between planar scan and PET/CT. Tumor dose estimated on 99mTc-MAA SPECT/CT was more effective than planar image for prediction of treatment response, with cutoff value 125 Gy (sensitivity of 86% and specificity of 75%). In conclusion, 99mTc-MAA SPECT/CT is more closely correlated with post-treatment 90Y PET/CT, and is more effective for predicting treatment response than planar scan. SPECT/CT is superior to planar image in simulation before 90Y TARE.

Serum neutrophil/lymphocyte ratio as a potential predictor of treatment response for immune checkpoint inhibitors in patients with advanced hepatocellular carcinoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16156-e16156
Author(s):  
Jian He ◽  
Zhiqiang Mo ◽  
Qicong Mai ◽  
Xiaoming Chen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Post Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Advanced Hcc ◽  
Lymphocyte Ratio ◽  
Pre Treatment

e16156 Background: Neutrophil to lymphocyte ratio (NLR) has been shown to associate with tumor progression. The present study was to investigate the role of NLR on predicting the treatment response for immune checkpoint inhibitors (ICIs) therapy in patients with advanced hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed 81 patients received ICIs for advanced HCC from January 2017 to July 2019. We analyzed whether pre- and first 3 weeks post- treatment serum NLR level was associated with ICIs outcome. Results: In this study, the pre-treatment NLR level ranged from 0.64 to 14.93 among 81 patients. The cut-off level of NLR was set as the median value of 2.79. The objective response rate (ORR) in the patients with NLR＜2.79 (low NLR) was 25.0%, which was significantly better than that of patients with NLR ≥2.79 (high NLR) (7.3%, P ＝0.03). Compared to patients with high NLR, patients with low NLR exhibited significantly longer median progression-free survival (PFS) (3.7 vs 3.0 months, P ＝0.004) and median overall survival (OS) (10.3 vs 7.5 months, P ＝0.001). Multivariate analysis revealed high NLR was an independent unfavourable prognostic factor for PFS (hazard ratio [HR] = 1.857, 95% confidence interval [CI] = 1.093-3.154; P = 0.022) and OS (HR = 2.267, 95% CI = 1.221-4.207; P = 0.009). For the patients with high pre-treatment NLR level, ICIs outcome was stratified more clearly by first 3 weeks post- treatment NLR level. Conclusions: The pre- and first 3 weeks post- treatment serum NLR level could be considered as a predictive factor of treatment response for ICIs in patients with advanced HCC.

Interim metabolic tumor volume to predict response in diffuse large B-cell lymphoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 7557-7557
Author(s):  
Prioty Islam ◽  
Jordan Goldstein ◽  
Ila Sethi ◽  
Daniel Lee ◽  
Christopher Flowers
Keyword(s):  
Treatment Response ◽  
Predictive Value ◽  
Tumor Volume ◽  
Post Treatment ◽  
Ct Scans ◽  
Fdg Uptake ◽  
Interim Pet ◽  
End Of Treatment ◽  
Pet Ct ◽  
Pre Treatment

7557 Background: DLBCL is a heterogeneous disease with varied clinical outcomes following treatment with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). [18F] fluorodeoxyglucose (FDG) – positron emission tomography (PET)/computed tomography (CT) imaging is ubiquitously used in monitoring of DLBCL. PET-derived metrics for analysis of tumor FDG uptake include: tumor maximum standardized uptake value (SUV); metabolically active tumor volume (MTV); and total lesion glycolysis (TLG), calculated from the intensity of FDG uptake in tumor volume. We evaluated the predictive value of interim SUV, MTV and TLG for patients (pts) with DLBCL treated with R-CHOP. Methods: Pts with DLBCL treated at Emory University 2005-2016 were eligible. Cases were included if there was a diagnosis of DLBCL confirmed by record review, available information on date of diagnosis, date of last contact or date of death. Analyses were restricted to patients who received R-CHOP and had PET/CT scans available at baseline, Cycle 2 or 4 and end of treatment. Maximum SUV, MTV, and TLG were calculated using MIM software for tumor with an SUV threshold of > 4. Logistic regression analysis was used to calculate the predictive value of interim PET/CT metrics on end of treatment response. Results: Pre-treatment PET/CT scans for 42 patients were identified, along with 28 interim and 31 post-treatment scans. The mean pre-treatment MTV was 303ml (range 4 – 1,327) and mean TLG was 3188 (range 28 – 16,176). MTV and TLG were undetectable in 79% of interim scans and 74% of the post-treatment scans. A Deauville score of 3 or less was observed in 71% of the interim PET/CT scans and 56% of the post-treatment scans. A positive interim MTV was correlated with a positive post-treatment MTV and post-treatment Deauville score at 0.58 and 0.66, respectively, and a positive interim MTV result was a significant predictor of a positive post-treatment MTV result (p = 0.02). Conclusions: PET-derived metrics of assessing interim tumor response to therapy offer significant predictive value for end of treatment response, and can guide a response-adapted treatment approach for DLBCL pts that builds on the R-CHOP backbone.

scholarly journals 18F-FDG-PET/CT in radiation therapy-induced parotid gland inflammation

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Alaa Mouminah ◽  
Austin J. Borja ◽  
Emily C. Hancin ◽  
Yu Cheng Chang ◽  
Thomas J. Werner ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Post Treatment ◽  
Parotid Glands ◽  
Positron Emission ◽  
Pet Ct ◽  
Average Maximum ◽  
Pre Treatment ◽  
Fdg Pet Ct

Abstract Background 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used in the clinical management of oncologic and inflammatory pathologies. It may have utility in detecting radiotherapy (RT)-induced damage of oral tissues. Thus, the aim of the present study was to use FDG-PET/CT to evaluate parotid gland inflammation following RT in patients with head and neck cancer (HNC). Methods This retrospective study included patients with HNC treated with photon, proton, or combined photon/proton RT, in addition to chemotherapy. All patients received FDG-PET/CT imaging pre-treatment and 3 months post-treatment. The average mean standardized uptake value (Avg SUVmean) and the average maximum standardized uptake value (Avg SUVmax) of the left and right parotid glands were determined by global assessment of FDG activity using OsiriX MD software. A two-tailed paired t test was used to compare Avg SUVmean and Avg SUVmax pre- and post-RT. Results Forty-seven HNC patients were included in the study. Parotid gland Avg SUVmean was significantly higher at 3 months post-treatment than pre-treatment (p < 0.05) in patients treated with photon RT, but no significant differences were found between pre- and post-treatment Avg SUVmean in patients treated with proton RT or combined photon/proton RT. Conclusion Our results suggest that photon RT may cause radiation-induced inflammation of the parotid gland, and that proton RT, which distributes less off-target radiation, is a safer treatment alternative.

scholarly journals Prognostic Nutritional Index and its Dynamics After Curative Treatment are Independent Prognostic Factors on Survival in Non-Metastatic Nasopharyngeal Carcinoma

2021 ◽  
Author(s):  
Ahmet Küçükarda ◽  
Bülent Erdoğan ◽  
Ali Gökyer ◽  
Sezin Sayın ◽  
İvo Gökmen ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Nasopharyngeal Cancer ◽  
Prognostic Nutritional Index ◽  
Prognostic Indicator ◽  
Post Treatment ◽  
Curative Treatment ◽  
Predictive Values ◽  
Free Survival ◽  
Nutritional Index ◽  
Pre Treatment

Abstract Purpose: We aimed to identify the prognostic and predictive values of post-treatment prognostic nutritional index (PNI) and PNI dynamics in nasopharyngeal cancer patients (NPC) in this study.Methods: 107 non-metastatic NPC patients were included. PNI was calculated by using the following formula: [10 x serum albumin value (gr/dL)] + [0.005 x total lymphocyte count (per mm3)]. ROC analysis was used for determining prognostic PNI values and univariate and multivariate statistical analyses for prognostic characterization of PNI. Results: The statistically significant cut-off values for pre-and post-treatment PNI were 50.65 and 44.75, respectively. Of the pre-treatment PNI analysis, PNI≤50.65 group had shorter loco-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Furthermore, for post-treatment PNI analysis, PNI≤44.75 group had shorter LRRFS and OS. In univariate analysis, only pre-treatment PNI was associated with LRRFS and DMFS, while pre-and post-treatment PNI were both associated with OS. In multivariate analysis, both PNI were independent prognostic markers for OS. In the combined analysis, pre-and post-treatment PNI, differences between the groups were statistically significant, and the PNI dynamics was an independent prognostic indicator for OS. Conclusion: PNI is a useful, independent prognostic marker for non-metastatic NPC patients. It is used for either pre-or post-treatment patients. Furthermore, changes in pre-treatment PNI value after curative treatment is a significant indicator for OS.

Pretreatment metabolic tumor volume (MTV) as a predictor of survival in borderline resectable pancreatic cancers treated with neoadjuvant therapy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 310-310
Author(s):  
Alex Cruz ◽  
Dung-Tsa Chen ◽  
William J. Fulp ◽  
Michael Chuong ◽  
Sarah Hoffe ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Radiation Therapy ◽  
Surgical Resection ◽  
Tumor Volume ◽  
Metabolic Tumor Volume ◽  
Post Treatment ◽  
Ct Scans ◽  
Borderline Resectable ◽  
Pet Ct ◽  
Pre Treatment

310 Background: A higher initial metabolic tumor burden is associated with lower median survival in locally advanced pancreatic cancer (LAPC), yet the prognostic utility of PET/CT is not defined in the setting of borderline resectable pancreatic cancer (BRPC). Methods: We performed a retrospectivereview of our institutional experience treating BRPC. Initial staging included endoscopic ultrasound as well as pancreatic protocol CT and PET/CT scans. All patients underwent neoadjuvant gemcitabine-based chemotherapy and radiation therapy (RT). RT was delivered using standard fractionation intensity modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT). Restaging CT and PET/CT scans were obtained approximately 4 weeks following RT completion. We measured the significance of the pre-treatment and post-treatment SUV maximum and metabolic tumor volume (MTV) 2.5 to 5.0, which was defined as the MTV above a threshold SUV of 2.5, 3.0, 4.0 and 5.0. Cox regression models were used to evaluate the significance between these parameters and disease free survival (DFS) and overall survival (OS). Results: We evaluated a total of 72 BRPC patients. Median follow up was 12.7 months. 56 patients (77%) received induction chemotherapy with gemcitabine, docetaxel and capecitabine (GTX). 43 (59.7 %) underwent surgical resection. Significant predictors for OS in the whole cohort included pre-treatment SUV maximum (p=0.0042), post-treatment SUV maximum (p=0.0183), pre-treatment MTV 2.5 (p=0.0016) and pre-treatment MTV 4.0 (p=0.0111). In addition, the difference between the MTV 4.0 pre-treatment and post-treatment was significant (p=0.0285). In patients who underwent surgical resection, there was a significant correlation between OS with pre-treatment SUV max (p=0.0229) and post-treatment SUV maximum (p=0.0325) but not pre-treatment MTV 2.5 (p=0.0654) nor MTV 4.0 (p=0.0928) nor the differences between each variable pre (0.1482) or post-treatment (0.0959). Conclusions: This is the first study to suggest that pre and post treatment PET activity is prognostic for BRPC.

Circulating tumor DNA analysis for outcome prediction in localized esophageal cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4055-4055 ◽  
Author(s):  
Tej D. Azad ◽  
Aadel Chaudhuri ◽  
Aaron M. Newman ◽  
Henning Stehr ◽  
Joseph Schroers-Martin ◽  
...  
Keyword(s):  
Dna Analysis ◽  
Circulating Tumor Dna ◽  
Post Treatment ◽  
Strongly Correlated ◽  
Median Concentration ◽  
Pet Ct ◽  
Pre Treatment ◽  
Ctdna Analysis ◽  
Esophageal Carcinomas ◽  
Tumor Dna

4055 Background: Blood-based biomarkers are not used in routine clinical practice in patients with esophageal carcinomas (ECs). Circulating tumor DNA (ctDNA) is an attractive biomarker that could be applied to ECs. We performed a study to explore pre- and post-treatment ctDNA analysis using the next generation sequencing-based CAPP-Seq method as a prognostic biomarker for localized EC. Methods: We prospectively enrolled 29 patients with localized EC treated with chemoradiotherapy (CRT) between June 2011 and October 2015. 12 (43%) patients were treated with CRT alone and 17 (57%) were treated with CRT followed by esophagectomy. Our cohort included patients with stage IB (1; 3.4%), II (7; 24.1%), and III (21; 72.4%) disease. Eight (27.6%) harbored squamous cell carcinoma (SCC) and 21 (72.4%) adenocarcinoma (AC). All patients received pre-treatment evaluation by thoracic CT, PET/CT, and esophagoduodenoscopy. ctDNA levels were quantitated in pre-treatment and post-treatment plasma samples using CAPP-Seq. Results: Median follow-up time was 21 months. We detected ctDNA pre-treatment in 72.4% of cases (N = 21) with a median concentration of 2.69 haploid genome equivalents per mL (hGE/mL; range 0.34-107.3). Pre-treatment ctDNA concentrations were strongly correlated with metabolic tumor volumes (MTV; R2= 0.74; p = 1.7e-07) and were significantly higher in SCC than AC patients (28.2 vs. 2.1 mean hGE/mL; p = 0.002). Overall survival (OS) at 2 years for pretreatment ctDNA+ vs. ctDNA- patients was 47% vs. 86% (HR = 6.0; 95% CI = 0.74-49.2; p < 0.05) and trended toward significance when accounting for stage, histology, and age (p = 0.09). A single post-treatment plasma sample was collected within 3 months of treatment and was available for 19 patients. Post-treatment ctDNA was detected in 3 (15.7%) patients with a median concentration of 11.5 hGE/mL (range 2.2–11.9). Post-treatment ctDNA detection was strongly predictive of poor event-free survival (p < 0.0001) and time to distant metastasis (p < 0.0001). Conclusions: Our data suggest that pre- and post-treatment ctDNA levels may be prognostic for patients with localized EC and could potentially guide risk-adapted adjuvant therapy approaches.

scholarly journals DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0144770 ◽  
Author(s):  
Ann D. King ◽  
Steven Kwok Keung Chow ◽  
Kwok-Hung Yu ◽  
Frankie Kwok Fai Mo ◽  
David K. W. Yeung ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Treatment Response ◽  
Squamous Cell ◽  
Post Treatment ◽  
Dce Mri ◽  
Treatment Assessment ◽  
Treatment Prediction ◽  
Pre Treatment

scholarly journals 18F-FDG-PET/CT for Evaluation of treatment response in high grade lymphoma

2017 ◽  
Vol 1 (1) ◽  
pp. 42-52
Author(s):  
Yadav Ajay Kumar ◽  
Kumar Rakesh ◽  
Malhotra Arun ◽  
Sharma Atul
Keyword(s):  
Treatment Response ◽  
Fdg Pet ◽  
High Grade ◽  
Predictive Values ◽  
Pet Ct ◽  
18F Fdg ◽  
Ct Data ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct ◽  
Post Therapy

18F-FDG PET is highly sensitive and specific for evaluation of the treatment response of high-grade lymphomas. The molecular information provided by 18F-FDG-PET identifies the functional content of anatomic finding and helps to categorize their nature as malignant or benign. On the other hand, the CT data obtained in the same setting provides anatomical localization of the 18F-FDG-PET data while also improving the FDG-PET image quality as it is utilized for attenuation correction. Previously, most of the studies were done on this topic by using 18F-FDG-PET alone. Present study was planning to assess the role of 18F-FDG-PET/CT in evaluation of treatment response in patient of HD and NHL. Results showed that 43 patients out of 52 showed no pathologic FDG uptakes, whereas 9 showed persistent uptakes. Among the 43 patients who had negative PET scans, only three relapsed, whereas among the 9 patients who had persistent abnormal 18F-FDG uptakes on post therapy PET/CT scans, two recovered. The sensitivity, specificity, positive and negative predictive values and accuracy of post therapy PET/CT scan was 70%, 95%, 78%, 93%, and 90% respectively.

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