Prognostic Value of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography Imaging in Patients With Advanced-Stage Non–Small-Cell Lung Carcinoma

2008 ◽  
Vol 26 (9) ◽  
pp. 1459-1464 ◽  
Author(s):  
Jenny K. Hoang ◽  
Luke F. Hoagland ◽  
R. Edward Coleman ◽  
April D. Coan ◽  
James E. Herndon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Small Cell ◽  
Emission Tomography ◽  
Advanced Stage ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Fluorine 18 Fluorodeoxyglucose

Purpose To determine whether the amount of fluorine-18 fluorodeoxyglucose (FDG) uptake in the primary lung cancer on positron emission tomography (PET) imaging at the time of presentation has prognostic significance in patients with advanced-stage non–small-cell lung cancer (NSCLC). Patients and Methods A retrospective review identified 214 patients with advanced-stage NSCLC (stage IIIA, IIIB, and IV) who underwent FDG PET study at the time of diagnosis. Extensive clinical data, including tumor histologic cell type, pathologic stage at presentation, and treatment, were recorded. The maximum standardized uptake value (SUVmax) in the primary tumor on FDG PET on survival was examined using Cox proportional hazards regression. Results One hundred fifty-eight (74%) of the 214 patients died and 56 patients were reported alive at 27 months (range, 3 to 140 months) after the diagnosis of NSCLC. Using the median SUVmax of 11.1, the patient population was subdivided. The median survival of the 106 patients with the primary tumor having an SUVmax less than 11.1 was 16 months (95% CI, 12 to 21 months), whereas the median survival of the 108 patients with the primary tumor having an SUVmax ≥ 11.1 was 12 months (95% CI, 10 to 15 months). Univariate and multivariate analysis did not provide evidence that survival for patient subgroups defined by the median SUVmax were significantly different (univariate P = .11; multivariate P = .45). Conclusion FDG uptake of the primary lesions in patients with a new diagnosis of advanced-stage NSCLC does not have a significant relationship with survival.

Prognostic Stratification of Stage IIIA-N2 Non–Small-Cell Lung Cancer After Induction Chemotherapy: A Model Based on the Combination of Morphometric-Pathologic Response in Mediastinal Nodes and Primary Tumor Response on Serial 18-Fluoro-2-Deoxy-Glucose Positron Emission Tomography

2008 ◽  
Vol 26 (7) ◽  
pp. 1128-1134 ◽  
Author(s):  
Christophe Dooms ◽  
Eric Verbeken ◽  
Sigrid Stroobants ◽  
Kris Nackaerts ◽  
Paul De Leyn ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Small Cell ◽  
Emission Tomography ◽  
Overall Survival Rate ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Positron Emission ◽  
Mediastinal Disease

Purpose Surgical resection in patients with stage IIIA-N2 non–small-cell lung cancer (NSCLC) is usually reserved for patients with mediastinal downstaging after induction chemotherapy (IC). However, clinical restaging is often inaccurate, and there are insufficient data to conclude that all patients with persistent mediastinal disease will not benefit from surgery, or that all patients with mediastinal clearance benefit from surgery. We created a data-based restaging strategy combining morphometric tissue analysis of mediastinal lymph nodes (LNs) and 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) response monitoring in the primary tumor. Patients and Methods Baseline and repeat FDG-PET after IC, as well as complete resection specimens of both mediastinal LNs and primary tumor, were available in 30 patients. Histologic response grading was performed by means of conventional morphometric procedures. Mediastinal response grading combined with the percentage decrease of maximum standardized uptake value (SUVmax) on the primary tumor was correlated with survival. Results Patients with persistent major mediastinal LN involvement have a 5-year overall survival rate of 0%. The 5-year overall survival rate for patients with cleared or persistent minor mediastinal LN involvement was significantly higher in patients with a more than 60% decrease in SUVmax on the primary tumor as compared with patients with a less than 60% decrease in SUVmax (62% v 13%; log-rank P = .002). Conclusion These data may suggest that (1) persistent mediastinal disease after IC does not always exclude favorable outcome after surgery; (2) serial FDG-PET may select surgical candidates among patients with mediastinal downstaging or persistent minor disease; (3) persistent major mediastinal disease has a poor prognosis and such patients should not be considered for surgery.

Use of early 18f-fluorodeoxyglucose-positron emission tomography to predict clinical outcome of patients with advanced non-small cell lung cancer on gefitinib treatment versus carboplatin plus paclitaxel.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10577-10577
Author(s):  
Masaki Kanazu ◽  
Kaoru Maruyama ◽  
Masahiko Ando ◽  
Kazuhiro Asami ◽  
Mari Ishii ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Small Cell ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Fluorodeoxyglucose Positron Emission

10577 Background: Early prediction of clinical efficacy is of great value in cancer patients in avoiding unnecessary toxicities and giving them another chance for different treatments. This study aimed to assess the 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) at 3 days on treatment as an early predictor of clinical outcome in patients with advanced non-small cell lung cancer (NSCLC) treated with gefitinib and in those treated with cytotoxic chemotherapy. Methods: This study comprised two groups: patients with stage IIIB or IV NSCLC were treated with gefitinib (250mg) once daily (gefitinib group) or with carboplatin (AUC 6, day 1) plus paclitaxel (200mg/m2, day 1) q21 days (CP group) according to the physicians’ choice. FDG-PET was performed before, 3 days on and 28 days on each treatment. Reduction of tumor FDG uptake was assessed by using standardized uptake value (SUV). Metabolic response was defined as reduction of FDG uptake in the tumor ≥ 25% according to the criteria of the European Organization for Research and Treatment of Cancer. Metabolic response was correlated with clinical outcomes. Results: This study included 38 patients: 19 in gefitinib group and 19 in CP group. Reduction of SUV at 3days on treatment preceded tumor shrinkage more closely in gefitinib group. Metabolic response was significantly correlated with longer progression-free survival (PFS) in gefitinib cohort (median PFS 15.8 months [95% CI 13.2-18.4] vs. 3.7 months [95% CI 0.1-8.0], p < 0.001), but not in CP group (median PFS 5.7 months vs. 2.9 months, p = 0.054). Furthermore, metabolic response was significantly correlated with longer overall survival (OS) in gefitinib group (median OS 28.7 months [95%CI 23.5-33.9] vs. 9.8 months [95% CI 2.1-17.5], p = 0.009), but not in CP group (median OS 13.9 months vs. 10.5 months, p = 0.56). In multivariate analysis using Cox hazards models, metabolic response was a significant predictive factor of PFS and OS. Conclusions: Reduction of SUV levels on FDG-PET at 3 days on treatment may predict response and survival in gefitinib-treated patients with advanced NSCLC.

scholarly journals Can positron emission tomography - computed tomography imaging predict of metastases in patients with small cell lung cancer

2020 ◽  
Vol 8 (5) ◽  
pp. 1644
Author(s):  
Ngo Minh Xuan ◽  
Huynh Quang Huy
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Small Cell Lung Cancer ◽  
Tumor Size ◽  
Primary Tumor ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Pet Ct

Background: Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. positron emission tomography - computed tomography (PET/CT) has become increasingly used as an initial staging tool in patients with SCLC. We aimed to explore the relationships between primary tumor 18F-FDG uptake measured as the maximum standardized uptake value (SUV max) and clinical stage at PET/CT for small cell lung cancer patients (SCLC).Methods: Patients with SCLC who underwent 18F-FDG PET/CT scans before the treatment were included in the study at Bach Mai hospital of Vietnam, from November 2014 to May 2018. The primary tumor and secondary lesion SUVmax was calculated; the tumor size was measured; the TNM status was determined mainly by FDG PET/CT imaging according to The 8th Edition of the TNM Classification for Lung Cancer were recorded. An evaluation was made of the linear relationship between tumor size, T stage, N stage, and M stages of the patients and their SUVmax using Spearman’s correlation.Results: Total 37 cases (34 men and 3 women; age range 38 - 81 years, median 64 years) were analyzed. The average of primary tumor size and SUVmax were 5.95±2.77 cm and 10.21±4.75, respectively. The SUVmax of primary tumor is significantly greater than that of nodal and distant organ metastasis (10.21±4.75 vs 8.20±4.35 and 6.44±3.17, p<0.01). There was a moderate correlation between SUVmax and tumor size (r =0.596, p<0.001), tumor stage (r = 0.502, p<0.01) but not significant with nodal stage (r =-0.218, p=0.194), metastasis stage (r = -0.055, p=0.747), and overall stage (r=-0.060, p=0.725).Conclusions: SUVmax was significantly correlated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases in patients with SCLC.

Positron Emission Tomography in Non–Small-Cell Lung Cancer: Prediction of Response to Chemotherapy by Quantitative Assessment of Glucose Use

2003 ◽  
Vol 21 (14) ◽  
pp. 2651-2657 ◽  
Author(s):  
Wolfgang A. Weber ◽  
Volker Petersen ◽  
Burkhard Schmidt ◽  
Leishia Tyndale-Hines ◽  
Thomas Link ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Best Response ◽  
Positron Emission ◽  
Response To Chemotherapy

Purpose: To prospectively evaluate the use of positron emission tomography with the glucose analog fluorodeoxyglucose (FDG-PET) to predict response to chemotherapy in patients with advanced non–small-cell lung cancer (NSCLC). Patients and Methods: Patients with stage IIIB or IV NSCLC scheduled to undergo platinum-based chemotherapy were eligible for this study. Patients were studied by FDG-PET before and after the first cycle of therapy. Based on previous studies, a reduction of tumor FDG uptake by more than 20% as assessed by standardized uptake values (SUV) was used as a criterion for a metabolic response. Furthermore, changes in tumor SUVs were compared with changes in FDG net-influx constants (Ki) and tumor/muscle ratios (t/m). Results: Fifty-seven patients were included in the study. There was a close correlation between metabolic response and best response to therapy according to Response Evaluation Criteria in Solid Tumors (P < .0001; sensitivity and specificity for prediction of best response, 95% and 74%, respectively). Median time to progression and overall survival were significantly longer for metabolic responders than for metabolic nonresponders (163 v 54 days and 252 days v 151 days, respectively). Similar results were obtained when Ki was used to assess tumor glucose use, whereas changes in t/m showed considerable overlap between responding and nonresponding tumors. Conclusion: In NSCLC, reduction of metabolic activity after one cycle of chemotherapy is closely correlated with final outcome of therapy. Using metabolic response as an end point may shorten the duration of phase II studies evaluating new cytotoxic drugs and may decrease the morbidity and costs of therapy in nonresponding patients.

Prognostic Relevance of Response Evaluation Using [18F]-2-Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography in Patients With Locally Advanced Non–Small-Cell Lung Cancer

2005 ◽  
Vol 23 (33) ◽  
pp. 8362-8370 ◽  
Author(s):  
Corneline J. Hoekstra ◽  
Sigrid G. Stroobants ◽  
Egbert F. Smit ◽  
Johan Vansteenkiste ◽  
Harm van Tinteren ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Small Cell Lung Cancer ◽  
Fdg Pet ◽  
Graphical Analysis ◽  
Small Cell ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Positron Emission

Purpose The objective of this study was to determine the accuracy of (early) response measurements using [18F]-2-fluoro-2-deoxy-D-glucose positron emission tomography (18FDG PET) with respect to survival of patients with stage IIIA-N2 non–small-cell lung cancer (NSCLC) undergoing induction chemotherapy (IC), with a comparative analysis of PET methods. Patients and Methods In a prospective multicenter study, PET was performed in patients before IC and after one and three cycles. Computed tomography (CT) was performed before and after IC. Glucose consumption (metabolic rate of glucose [MRglu]) was measured using Patlak graphical analysis and correlated with simplified methods. Mediastinal lymph node (MLN) status was assessed visually. Cox proportional hazards analysis was used to determine the prognostic relevance of CT and PET measures of response with respect to survival. Results Complete PET data sets were available in 47 patients. Median survival was 21 months. MLN status after IC by PET predicted survival (hazard ratio [HR], 2.33; 95% CI, 1.04 to 5.22; P = .04) in contrast with CT (HR, 1.87; 95% CI, 0.81 to 4.30; P = .14). Residual MRglu after IC proved to be the best prognostic factor (HR, 1.95; 95% CI, 1.28 to 2.97; P = .002). Multivariate stepwise analysis showed that PET identified prognostically different strata in patients considered responsive according to CT. Residual MRglu after one cycle selected patients with different outcomes (HR, 2.04; 95% CI, 1.18 to 3.52; P = .01). Simplified quantitative 18FDG PET methods were correlated with Patlak graphical analysis during and after therapy (r ≥ 0.90). Conclusion 18FDG PET has additional value over CT in monitoring response to IC in patients with stage IIIA-N2 NSCLC, and it seems feasible to predict survival early during IC. Simple semiquantitative and complex PET methods perform equally well.

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