Metabolic Response by 18F-FDG PET/CT in Metastatic Malignant Struma Ovarii Treated With Targeted Therapies

Abstract Aim To evaluate the feasibility of early metabolic response assessment with 18F-FDG PET/CT in patients with breast cancer liver metastases 4 weeks after radioembolization with Yttrium-90 labeled microspheres. Methods 25 patients (mean age 58y, range 40–74) with advanced stage liver metastases of breast cancer were treated with 1.9 ± 0.4 GBq of 90Y-microspheres in the salvage setting and underwent 18F-FDG PET/CT at baseline and 4 weeks post-radioembolization. 14 patients (56 %) had an excessive hepatic tumor burden (> 50 % of total liver volume), 21 patients (84 %) had extrahepatic disease. Liver lesions with the highest SUVmax were selected as target lesions and a cut-off was set at 50 % reduction to separate responders from non-responders. The predictive impact of metabolic response on overall survival (OS) was investigated along with other prognostic factors. Results The median OS in this highly advanced metastatic cohort was 7 months (95 % CI, 5–9). All patients had a reduction in SUVmax (mean ΔSUVmax: –49 ± 26 %) at 4 weeks post-treatment. Patients with > 50 % SUVmax reduction survived longer (median OS 13 mo, 95 % CI 8–18) than the remaining patients (median OS 4 mo, 95 % CI 2–6; p = 0.001). From all investigated baseline factors including age, performance status, and presence of extra-hepatic disease, only the hepatic tumor burden had a significant impact on OS (p = 0.02). Conclusions This is the first preliminary evidence in breast cancer that early post-radioembolization molecular response assessment of treated liver metastases – as early as 4 weeks posttreatment – may predict survival. If confirmed by larger series, FDG PET/CT could be considered for early response-adapted treatment modifications.

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Early response evaluation using 18F-FDG-PET/CT does not influence management of patients with metastatic gastrointestinal stromal tumors (GIST) treated with palliative intent

Nuklearmedizin ◽

10.1055/a-1542-6211 ◽

2021 ◽

Vol 60 (06) ◽

pp. 411-416

Author(s):

Sheima Farag ◽

Nikki S. IJzerman ◽

Matthijs P.M. Houdijk ◽

An K.L. Reyners ◽

Anne IJ Arens ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Early Response ◽

Ct Scans ◽

Palliative Intent ◽

Metastatic Gist ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

The Impact

Abstract Aim The aim of this study was to investigate the impact of 18F-FDG-PET/CT on treatment decision making in metastatic gastrointestinal stromal tumor (GIST) patients. Methods This study retrospectively evaluated 18F-FDG-PET/CT scans to monitor response of metastatic GIST patients treated with palliative intent. Data from the Dutch GIST Registry was used. Early scans (<10 weeks after start of treatment) and late scans (>10 weeks after start of treatment) were scored on the impact in change of treatment. Results Sixty-one PET/CT scans were performed for treatment evaluation in 39 patients with metastatic GIST of which 36 were early scans and 25 were late scans. Early PET/CT scans led to a change in management in 5.6% of patients and late PET/CT scans led to a change in management in 56% of patients. Change in management was more often seen after scans with lack of metabolic response (48% vs. 11% in scans with metabolic response, p=0.002). Neither metabolic response nor change in treatment were more often seen in patients with KIT mutations compared to patients with non-KIT mutations (metabolic response 65% KIT vs. 46% non-KIT, p=0.33, and change in management 28% KIT vs. 21% non-KIT, p=0.74). Conclusion 18F-FDG-PET/CT is not recommended for early response evaluation in an unselected patient population with metastatic GIST, since it does not influence treatment decisions. 18F-FDG-PET/CT, however, can be useful for late response assessment, especially in case of indeterminate CT results.

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18F-FDG-PET/CT in predicting pathologic complete response after neoadjuvant chemotherapy: The early metabolic response is the answer

European Journal of Cancer ◽

10.1016/j.ejca.2013.07.151 ◽

2013 ◽

Vol 49 (16) ◽

pp. 3573-3574

Author(s):

Salome Sanz-Viedma ◽

Alfonso Sanchez-Muñoz ◽

Victoria Scholz-Gutierrez ◽

Jose Manuel Jimenez-Hoyuela ◽

Abass Alavi ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Fdg Pet ◽

Metabolic Response ◽

Pathologic Complete Response ◽

Complete Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Early Metabolic Response

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OC-0562: Application of low dose 18F-FDG PET/CT for frequent metabolic response monitoring ñ a logistical challenge

Radiotherapy and Oncology ◽

10.1016/s0167-8140(15)40557-2 ◽

2015 ◽

Vol 115 ◽

pp. S274-S275

Author(s):

N.M. Bruin ◽

J.B. Kamer van de ◽

J.L. Knegjens ◽

S.L. Takken ◽

J.J. Sonke ◽

...

Keyword(s):

Fdg Pet ◽

Low Dose ◽

Metabolic Response ◽

Response Monitoring ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Absence of early metabolic response assessed by 18F-FDG PET/CT after initiation of antifibrotic drugs in IPF patients

Respiratory Research ◽

10.1186/s12931-019-0974-5 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Benjamin Bondue ◽

Amélie Castiaux ◽

Gaetan Van Simaeys ◽

Céline Mathey ◽

Félicie Sherer ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Early Metabolic Response ◽

Antifibrotic Drugs

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[ 18F]-FDG-PET/CT correlates with the response of radiorefractory thyroid cancer to lenvatinib and patients’ survival

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab278 ◽

2021 ◽

Author(s):

Laura Valerio ◽

Federica Guidoccio ◽

Carlotta Giani ◽

Elisa Tardelli ◽

Giulia Puccini ◽

...

Keyword(s):

Thyroid Cancer ◽

Ct Scan ◽

Fdg Pet ◽

Metabolic Response ◽

Whole Body ◽

Morphological Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Pet Ct Scan

Abstract Introduction [18F]-FDG-PET/CT positive metastatic lesions in radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) have a poor prognosis and lenvatinib represents the best therapy. We investigated the role of [ 18F]-FDG-PET/CT in the evaluation of metabolic response and prediction of the outcome of RAI-R DTC patients treated with lenvatinib. Materials and Methods Thirty-three progressive metastatic RAI-R DTC patients treated with lenvatinib were investigated at baseline and during follow-up with biochemical (Tg/TgAb), morphological (whole-body CT scan) and metabolic evaluation ([ 18F]-FDG-PET/CT). Results Nineteen of thirty-three (57.6%) patients showed the greatest metabolic response at the first [ 18F]-FDG-PET/CT scan, performed after 4 weeks of lenvatinib, while 5/33 (15.1%) patients had this response later. Moreover, 66.7% of patients had both a metabolic response at the first [ 18F]-FDG-PET/CT scan and a morphological response at the first CT scan. We observed a correlation between the metabolic response at [ 18F]-FDG-PET/CT scan performed after 4 weeks of treatment and the biochemical response at the same time in 60.6% of patients. The median overall survival (OS) was significantly longer in patients with either a metabolic response at last [ 18F]-FDG-PET/CT (40.00 vs 8.98 months) or a morphological response at last CT scan (37.22 vs 9.53 months) than in those without response. Moreover, the OS was longer in patients with a metabolic response at [ 18F]-FDG-PET/CT performed after 4 weeks of treatment (36.53 vs 11.28 months). Conclusions Our data show that [ 18F]-FDG-PET/CT can early predict the response to lenvatinib and correlates with the OS of RAI-R DTC patients treated with this drug.

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Diagnostic Performance of 18F-FDG PET/CT Semiquantitative Analysis in the Management of Sarcoidosis

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405614666180522075828 ◽

2018 ◽

Vol 15 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Giuseppe Rubini ◽

Cristina Ferrari ◽

Corinna Altini ◽

Alessandra Cimino ◽

Margherita Fanelli ◽

...

Keyword(s):

Fdg Pet ◽

Metabolic Response ◽

Statistical Significance ◽

Clinical Stage ◽

Whole Body ◽

Mean Values ◽

Pet Ct ◽

Response Groups ◽

18F Fdg ◽

Fdg Pet Ct

Background: Sarcoidosis is a multisystem granulomatous disorder of unknown origin characterized by nonspecific clinical symptomatology. 18F-FDG PET/CT can visualize activated inflammatory cells of sarcoidosis and simultaneously provide whole-body images. </P><P> Objective: To evaluate the clinical usefulness of 18F-FDG PET/CT and its semiquantitative parameters for the assessment of treatment efficacy in patients with sarcoidosis. Methods: Thirty-one consecutive patients who performed 18F-FDG PET/CT for sarcoidosis assessment were selected. All subjects performed 18F-FDG PET/CT before any treatment (PET1) and after 6-12 months (PET2). SUVmax and SUVmean on PET1 and PET2 were collected. SUVs values were employed to evaluate the ratios with the liver (R-LIVERmax, R-LIVERmean) and the blood (R-BLOODmax, R-BLOODmean). The difference between the PET1 and PET2 values was evaluated (ΔSUVmax, ΔSUVmean, ΔR-LIVERmax, ΔR-LIVERmean, ΔR-BLOODmax, ΔR-BLOODmean). Patients were classified as Responders (R), Partial-Responders (PR) and Non- Responders (NR). Results: Seventeen patients (54.8%) had a complete metabolic response (R), 4 (12.9%) were PR while 10 (32.3%) had no Metabolic Response (NR). The chi-square test showed that response groups were related neither to the stage of disease (p=0.59) nor to therapy performed (p<0.079). The comparison between each Δ semiquantitative parameter showed a statistically significant decrease from PET1 to PET2 (0.0001 < p < 0.002). The comparison between Δ mean values in relation to response groups showed to be statistically significant (0.001 < p < 0.005). Conversely, they did not show statistical significance in relation to the clinical stage groups and to the kind of therapy performed (p>0.05). Pearson’s coefficient demonstrated a reverse correlation between a number of sites still involved in disease after therapy and each Δ semiquantitative parameters (p≤0.0001). Conclusion: 18F-FDG PET/CT should be considered a useful technique for the evaluation of sarcoidosis and semiquantitative parameters. Further studies are needed to determine the long-term impact of 18F-FDG PET/CT on clinical outcomes.

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