RA07.06: BASELINE FDG-PET/CT PARAMETERS AS PREDICTOR FOR RESIDUAL TUMOUR AFTER NEOADJUVANT CHEMORADIOTHERAPY IN OESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 35-35
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Lean Body Mass ◽  
Body Mass ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Mass ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background An optimal model for predicting pathologic response after neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer has not been defined yet. FDG-PET/CT is frequently used in response assessments. The aim of this side study of the preSANO trial (NL41732.078.13) was to investigate if the FDG-PET parameters SUVmax, total lesion glycolysis (TLG) and metabolic tumour volume (MTV) were predictive for residual tumour in the resected specimen of oesophageal cancer patients treated with nCRT. Methods Patients underwent FDG-PET/CT at baseline according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.). All parameters were corrected for lean body mass. MTV was defined as the volume within a 41% of SULmax ( = SUV/lean body mass) isocontour threshold at tumour and lymph nodes. TLG was calculated as SULmean x MTV. Logarithmic transformation was performed because of non-normal distribution of TLG and MTV. Baseline PET parameters were compared to tumour regression grade in the resection specimen (TRG3–4 = > 10% residual tumour vs. TRG1 = complete response). Peroperatively irresectable tumours were recoded as TRG4. Analyses were performed using an independent-samples T-test. Results From a total of 207 patients who underwent FDG-PET/CT before nCRT, 197 were included for analysis (5 were non-FDG avid, 5 had incomplete data). Histological type of tumour: adenocarcinoma (AC) n = 154, squamous cell carcinoma (SCC) n = 42, and one adenosquamous carcinoma. Thirty-seven patients (19%) had TRG1 and 41 patients (21%) had TRG3–4. In complete responders (TRG1), SULmax, TLG and MTV (mean ± SD) were 9.6 ± 5.8, 85.3 ± 85.5 and 13.0 ± 9.9, respectively. In patients with TRG3–4, SULmax, TLG and MTV were 9.4 ± 5.4145.8 ± 164.6 and 21.9 ± 16.2, respectively. SULmax was not significantly different between both groups (P = 0.8), but log(TLG) and log(MTV) (P = 0.008 and P = 0.001) were. In adenocarcinomas, log(TLG) did not differ between groups (P = 0.1). Conclusion Initial FDG tumour mass, expressed as MTV, (rather than SULmax) is the most contributing factor in predicting residual disease after nCRT in both SCC and AC. The effect is stronger in SCC. Therefore, baseline FDG tumour mass should be included in a prediction model, besides other clinical and tumour parameters. Disclosure All authors have declared no conflicts of interest.

PS02.064: ACCURACY OF F-18-FDG-PET/CT IN MONITORING TUMOUR RESPONSE AFTER NEOADJUVANT CHEMORADIOTHERAPY IN PATIENTS WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 138-139
Author(s):  
Maria Valkema ◽  
B Noordman ◽  
Bas P L Wijnhoven ◽  
M C W Spaander ◽  
Sjoerd M Lagarde ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Conflicts Of Interest ◽  
False Negative ◽  
Neoadjuvant Chemoradiotherapy ◽  
Tumour Response ◽  
Distant Metastases ◽  
Residual Tumour ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background Neoadjuvant chemoradiotherapy (nCRT) induces a pathologically complete response in approximately 30% of patients with oesophageal cancer. To explore the possibility of safe postponement of surgery, accurate clinical response evaluations are needed to exclude residual disease. The present study aims to assess the value of F-18-FDG-PET/CT for the detection of residual tumour (> 10% tumour cells = TRG3–4 vs. no vital cells = TRG1) or metastases after nCRT. Methods FDG-PET/CT at baseline and 12 weeks after nCRT was performed according to the European Association of Nuclear Medicine guidelines 1.0 (2.3MBq/kg F-18-FDG; scanning 60 ± 5min.) and the protocol of the preSANO study. Qualitative analysis included sensitive reading of presence of residual tumour and/or metastases. A lesion was considered FDG-positive, when any uptake in the lesion itself was above the adjacent oesophageal background uptake. Quantitatively, SUV/lean body mass (SUL) measurements at tumour, lymph nodes, oesophagus, liver and bloodpool were recorded and compared with pathology (resection specimen: gold standard). Results Some 129 of 207 patients with FDG-avid tumours at baseline proceeded to FDG-PET/CT at around 12 weeks after nCRT just before surgery. Forty-one of 129 patients had TRG3–4, of whom 6 were missed on FDG-PET/CT (15% false negative) with SULmax 2.07 ± 0.25, SUL-ratio tumour/oesophagus (SULR) 1.35 ± 0.14. Sensitivity for TRG2–3-4 vs. TRG1 was 57/71 (80%). SULmax and SULR of FDG-positives were 3.76 ± 1.33 and 1.82 ± 0.69 respectively, compared to SULmax 2.21 ± 0.42 and SULR 1.31 ± 0.22 in FDG-negatives. Distant metastases were detected in 18 of 190 (10%) patients. Of all patients with postponed surgery, 12 had ≥ 1 additional FDG-PET/CT during follow-up (25–49.7 weeks after nCRT). Eventually, 4 patients underwent surgery. Three of 4 had increased FDG-signal and TRG3–4; 1 patient had decreased FDG-signal and no tumour left (TRG1). Conclusion FDG-PET/CT at around 12 weeks after nCRT misses TRG3–4 tumours in 15% and detects residual TRG2–3-4 in 80%. Furthermore, PET-CT detects distant metastases in 10% of patients after nCRT. These data indicate that serial FDG-PET may become valuable in an active surveillance approach. Disclosure All authors have declared no conflicts of interest.

scholarly journals Dynamic PET/CT Imaging of 68Ga-FAPI-04 in Chinese Subjects

2021 ◽  
Vol 11 ◽  
Author(s):  
Shuailiang Wang ◽  
Xin Zhou ◽  
Xiaoxia Xu ◽  
Jin Ding ◽  
Teli Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Body Mass ◽  
Fdg Pet ◽  
Radiation Dosimetry ◽  
Ct Imaging ◽  
Lung Cancer Patients ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Chinese Subjects

This study aims to further explore dynamic 68Ga-FAPI-04 PET/CT imaging of healthy Chinese subjects and lung cancer patients. Moreover, the variability of 68Ga-FAPI-04 uptake in normal organs was measured to provide a basis for analyzing its biological distribution, interpreting auxiliary images, determining the reliability of image quantification, and monitoring treatment. Six patients (3 subjects without tumors and 3 lung cancer patients) separately underwent 68Ga-FAPI-04 and 2-[18F]FDG PET/CT imaging within 1 week. The biodistribution and internal radiation dosimetry were reported and compared with data previously obtained from Caucasian patients. Moreover, the mean SUV (standardized uptake value) was normalized to body mass or to lean body mass (SUL), and the coefficients of variation (CVs) were calculated and compared for each volume of interest. The average whole-body effective dose was calculated to be 1.27E-02 mSv/MBq, which was comparable with previously reported results of 68Ga-FAPI-04 probes. Furthermore, the SUVmean was slightly higher than the SULmean in most organs; however, the CV of the SULmean for most organs was higher than that of the SUVmean at later time points. In the liver, the CV of the SUVmean was lower (12.7%) than that of the SULmean and was similar to the CV for corresponding 2-[18F]FDG PET/CT value (11.8%). In addition, 68Ga-FAPI-04 PET/CT showed good efficacy for diagnosing lung cancer patients in this study. A comparison of the radiation dosimetry obtained before from a Caucasian population demonstrated no clinically significant differences between these two populations after 68Ga-FAPI-04 injection. The variability in most organs was slightly lower for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantifying images obtained with 68Ga-FAPI-04. In addition, 68Ga-FAPI-04 PET/CT imaging is expected to be a promising tool for diagnosing lung cancer.

scholarly journals Prognostic Value of Sarcopenia in Patients Treated by Radiochemotherapy for Locally Advanced Oesophageal Cancer

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Pierre Decazes ◽  
Hugues Auvray ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Cancer Patients ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Prognostic Value ◽  
Locally Advanced ◽  
Ct Images ◽  
Pet Ct ◽  
Nutritional Risk Index ◽  
Fdg Pet Ct

Abstract Background Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer patients treated by curative-intent chemo-radiotherapy. Methods The clinical, nutritional, anthropometric, and functional-imaging ( 18 FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution (RTEP3). The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3 rd . lumbar vertebra level and divided by the patient’s squared height (SML3/h 2 ) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability. Results Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that reduced SMI (Hazard Ratio 0.948 [0.919 - 0.978] and male sex (2.977 [1.427 - 6.213] were significantly associated to decreased survival. Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm 2 /m 2 . In women, the AUC was 0.65 (p=0.19). Conclusion Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18 FDG-PET/CT acquisitions

scholarly journals Prediction and diagnosis of interval metastasis after neoadjuvant chemoradiotherapy for oesophageal cancer using 18F-FDG PET/CT

2018 ◽  
Vol 45 (10) ◽  
pp. 1742-1751 ◽  
Author(s):  
Lucas Goense ◽  
Jelle P. Ruurda ◽  
Brett W. Carter ◽  
Penny Fang ◽  
Linus Ho ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Direct Determination of Lean Body Mass by CT in F-18 FDG PET/CT Studies: Comparison with Estimates Using Predictive Equations

2013 ◽  
Vol 47 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Chang Guhn Kim ◽  
Woo Hyoung Kim ◽  
Myoung Hyoun Kim ◽  
Dae-Weung Kim
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Fdg Pet ◽  
Direct Determination ◽  
Predictive Equations ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Ct Studies

scholarly journals 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0133690 ◽  
Author(s):  
Maarten C. J. Anderegg ◽  
Elisabeth J. de Groof ◽  
Suzanne S. Gisbertz ◽  
Roel J. Bennink ◽  
Sjoerd M. Lagarde ◽  
...  
Keyword(s):  
Decision Making ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Surgical Decision ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Surgical Decision Making

scholarly journals Reliability of standardized uptake value normalized to lean body mass using the liver as a reference organ, in contrast-enhanced 18F-FDG PET/CT imaging

2018 ◽  
Vol 147 ◽  
pp. 35-39 ◽  
Author(s):  
Nur Hafizah Mohad Azmi ◽  
Subapriya Suppiah ◽  
Chang Wing Liong ◽  
Noramaliza Mohd Noor ◽  
Salmiah Md. Said ◽  
...  
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Ct Imaging ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Liver Standardized Uptake Value Corrected for Lean Body Mass at FDG PET/CT

2015 ◽  
Vol 40 (1) ◽  
pp. e17-e22 ◽  
Author(s):  
Alin Chirindel ◽  
Krishna C. Alluri ◽  
Abdel K. Tahari ◽  
Muhammad Chaudhry ◽  
Richard L. Wahl ◽  
...  
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Pet Ct ◽  
Fdg Pet Ct

Clinical response assessment on DW-MRI compared with FDG-PET/CT after neoadjuvant chemoradiotherapy in patients with oesophageal cancer

2020 ◽  
Author(s):  
Sophie E. Vollenbrock ◽  
Francine E. M. Voncken ◽  
Doenja M. J. Lambregts ◽  
Monique Maas ◽  
Maarten L. Donswijk ◽  
...  
Keyword(s):  
Clinical Response ◽  
Oesophageal Cancer ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Response Assessment ◽  
Pet Ct ◽  
Fdg Pet Ct
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