Interim analysis of fluorodeoxyglucose uptake in patients with metastatic or recurrent gastric cancer treated with fluoropyrimidine based chemotherapy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 44-44
Author(s):  
Suk-young Lee ◽  
Jaeseon Uh ◽  
Sang Cheul Oh
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Fdg Pet ◽  
Interim Analysis ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Ct Scanning ◽  
Interim Pet ◽  
Pet Ct ◽  
Fdg Pet Ct

44 Background: The role of 18F-FDG PET/CT scanning in advanced gastric cancer (AGC) is still under investigation. We evaluated its prognostic role in patients with recurrent or metastatic AGC who received fluoropyrimidine based chemotherapy. Methods: Forty-six patients with metastatic or recurrent AGC who had the baseline and interim PET/CT scanning during the palliative chemotherapy were analyzed. The lesion with the highest SUVmax value among target lesions was determined to be a main target (SUVmax1), and interim SUVmax of the target lesion was measured after several cycles (4-12 cycles) of chemotherapy (SUVmax2). The formula calculating metabolic change follows: ΔSUVmax2-SUVmax1 (%) = (SUVmax2-SUVmax1)/SUVmax1 * 100 Results: Patients with SUVmax1 value > 6 had a significantly higher response rate than those with the lower SUVmax1 (73.9% vs. 26.1%, p=0.036). SUVmax2 < 5 was significantly associated with better overall survival (OS) (p=0.035) with univariate analysis. ΔSUVmax2- SUVmax1 > -20% or appearance of new lesions with 18F-FDG PET/CT scanning at interim analysis was significantly associated with worse OS (p=0.027). ΔSUVmax2- SUVmax1 > -20% or new lesions (p=0.03) was the only factor significantly independently associated with OS using multivariate analysis (Table). Female (p=0.028), SUVmax2 > 5 (p=0.002), and ΔSUVmax2-SUVmax1 value > -20% (p=0.004) were significantly associated factors with worse progression free survival (PFS) using univariate analysis. Both SUVmax2 (p=0.028) and ΔSUVmax2-SUVmax1 value (p=0.043) were the significant factors associated with PFS using multivariate analysis. Conclusions: Analysis ofmetabolic change by interim PET/CT scanning is useful in predicting prognosis in patients with recurrent or metastatic AGC undergoing fluoropyrimidine based chemotherapy. [Table: see text]

scholarly journals Prognostic Significance of Metabolic Parameters by 18F-FDG PET/CT in Thymic Epithelial Tumors

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 712
Author(s):  
Joohee Lee ◽  
Young Seok Cho ◽  
Jhingook Kim ◽  
Young Mog Shim ◽  
Kyung-Han Lee ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors ◽  
Masaoka Stage ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Background: Imaging tumor FDG avidity could complement prognostic implication in thymic epithelial tumors. We thus investigated the prognostic value of volume-based 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT parameters in thymic epithelial tumors with other clinical prognostic factors. Methods: This is a retrospective study that included 83 patients who were diagnosed with thymic epithelial tumors and underwent pretreatment 18F-FDG PET/CT. PET parameters, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured with a threshold of SUV 2.5. Univariate and multivariate analysis of PET parameters and clinicopathologic variables for time-to-progression was performed by using a Cox proportional hazard regression model. Results: There were 21 low-risk thymomas (25.3%), 27 high-risk thymomas (32.5%), and 35 thymic carcinomas (42.2%). Recurrence or disease progression occurred in 24 patients (28.9%). On univariate analysis, Masaoka stage (p < 0.001); histologic types (p = 0.009); treatment modality (p = 0.001); and SUVmax, SUVavg, MTV, and TLG (all p < 0.001) were significant prognostic factors. SUVavg (p < 0.001) and Masaoka stage (p = 0.001) were independent prognostic factors on multivariate analysis. Conclusion: SUVavg and Masaoka stage are independent prognostic factors in thymic epithelial tumors.

Baseline cell-free DNA (cfDNA) and metabolic tumor volume (MTV) independently predict outcome in metastatic chemorefractory colorectal cancer (mCRC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11569-11569
Author(s):  
Erwin Woff ◽  
Pashalina Kehagias ◽  
Caroline Vandeputte ◽  
Tarek Kamoun ◽  
Thomas Guiot ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Fdg Pet ◽  
Proportional Hazards ◽  
Progression Free Survival ◽  
Risk Groups ◽  
Cox Proportional Hazards ◽  
Prognostic Scores ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Independent Parameters

11569 Background: No validated prognostic biomarker is currently available for mCRC. This trial assessed cfDNA and MTV before treatment with regorafenib as prognostic biomarkers for progression-free survival (PFS) and overall survival (OS) in mCRC. Methods: After signed informed consent, mCRC patients were enrolled in a prospective non-randomized trial aiming to define unlikelihood to benefit from regorafenib (EudraCT number: 2012-005655-16) and assessed for cfDNA and FDG PET/CT MTV at baseline. cfDNA was extracted from 3mL of plasma and quantified using the Qubit 2.0 fluorometer. All target lesions were delineated on FDG PET/CT using a PERCIST-based threshold and their volumes were summed to obtain total MTV. MTV and cfDNA optimal cutoffs for OS and PFS prediction were determined by the Contal and O’Quigley’s method. MTV, cfDNA, age, gender, Body Mass Index (low, normal, high, obese), ECOG PS, number of chemotherapy lines (NCL), previous use of bevacizumab and presence of a KRAS mutation were included in a multivariate analysis. Results: MTV and cfDNA of 132 evaluable/141 eligible patients were well correlated (Spearman’s correlation coefficient = 0.70; p < 0.001) and risk groups for both PFS and OS were identified on the basis of cfDNA (cfDNA < 1 µg/mL; cfDNA≥1 µg/mL) and MTV (MTV < 100 cm³; 100-300 cm³; > 300 cm³). The multivariate analysis retained cfDNA, MTV, NCL, and obesity as independent parameters for PFS prediction, and cfDNA, MTV, NCL, BMI, and previous use of bevacizumab as independent parameters for OS prediction. Prognostic scores for PFS and OS were developed based on regression coefficients from the final Cox proportional hazards models. Prognostic scores for PFS (1.8 vs 5.3 months, HR: 3.15 for score ≥-3 vs < -3, (95% CI, 2.08-4.76); p < 0.001) and for OS (4.2 vs 13.9 months, HR: 4.59 for score ≥-6 vs < -6: (95% CI, 2.92-7.21); p < 0.001) both identified patients with much contrasted outcomes. Conclusions: Baseline cfDNA and MTV along with BMI parameters predict outcome in patients with mCRC before regorafenib onset. These parameters not related to treatment should be considered, if validated in further studies, as stratification factors in future clinical trials. Clinical trial information: 2012-005655-16.

scholarly journals The Prognostic Value of Whole-Body Suvmax of Nodal and Extranodal Lesions Detected By 18F-FDG PET-CT in Patients with Extranodal NK/T-Cell Lymphoma

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3918-3918
Author(s):  
Jin-Hua Liang ◽  
Chong-Yang Ding ◽  
Li Wang ◽  
Lei Fan ◽  
Tian-Nv Li ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
T Cell ◽  
Roc Curve ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
Univariate Analysis ◽  
Whole Body ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Purpose The aim of this study was to determine whether the sum of the SUVmax of all the nodal and extranodal lesions can predict prognosis in patients with extranodal natural killer/T-cell lymphoma (ENKTL). Methods We conducted a retrospective analysis of 54 patients with newly-diagnosed ENKTL who underwent pretreatment 18F-FDG PET/CT. Three new models (WB1SUVmax, WB2SUVmax, WB3SUVmax) on the basis of the whole-body SUVmax of 11 nodal lesions (waldeyer ring, neck, infraclvicular, axillary and pectoral, mediastinal, hilar, spleen, paraaortic, mesenteric, lilac, inguinal and femoral) and 10 extranodal lesions (upper aerodigestive tract, skin/subsutaneous, central nervous system and spinal canal, lung, myocardium, bone and bone marrow, bowel, renal and adrenal, liver and testis) were designed to predict the overall survival (OS) and progression-free survival (PFS) Results During follow-up period (median 33.2 months), 31 patients showed disease progression and 28 patients died from the disease. Receiver operating characteristics curve analysis showed cut-off values for SUVmax, WB1SUVmax, WB2SUVmax, WB3SUVmax of 9.9 (sensitivity 82.6%, specificity 50%, AUC 0.658, P =0.060), 16.0 (sensitivity 87.00%, specificity 68.20, AUC 0.742, P =0.002), 15.8 (sensitivity 86.96%, specificity 68.18%, AUC 0.800, P <0.001), 15.8 (sensitivity 91.30%, specificity 72.73%, AUC 0.837, P <0.001), respectively (Figure 1). Multivariate analysis, after adjusting for all the other parameters significantly related to OS and PFS in the univariate analysis, showed that WB3SUVmax was the independent predictor for both OS (hazard ratio 5.08, 95% CI 1.42-18.17, P =0.012) and PFS (hazard ratio 4.12, 95% CI 1.31-12.94, P =0.015) while SUVmax was not (Table 1). Conclusion Our results demonstrated the importance of the WBSUVmax, which was calculated on the basis of the sum of the SUVmax of 11 nodal and 10 extranodal lesions, as a prognostic factor in ENKTL patients. The use of WBSUVmax together with the IPI score may be useful for better prognostic discrimination in the future. Table 1. Univariate and multivariate Cox regression analysis for PFS and OS Univariate analysis (OS) Multivariate analysis (OS) Univariate analysis (PFS) Multivariate analysis (PFS) Characteristic HR (95%CI) P HR (95%CI) P HR (95%CI) P HR (95%CI) P WB3SUVmax£¾15.8 6.67 (2.48-17.92) <0.001 5.08 (1.42-18.17) 0.012 5.02 (2.12-11.86) <0.001 4.12 (1.31-12.94) 0.015 IPI¡Ý2 9.22 (3.13-27.11) <0.001 -- -- 6.81 (2.74-16.92) <0.001 -- -- Age>60 years 1.79 (0.32-1.95) 0.611 -- -- 1.72 (0.30-1.78) 0.489 -- -- ECOG PS>1 2.14 (0.73-6.21) 0.162 -- -- 1.89 (0.66-5.42) 0.239 -- -- LDH>ULN 7.64 (2.87-20.33) <0.001 -- -- 5.85 (2.48-13.79) <0.001 -- -- Stage III or IV 5.22 (2.16-12.63) <0.001 -- -- 4.45 (2.00-9.89) <0.001 -- -- Extranodal sites£¾1 3.35 (1.55-7.22) 0.002 -- -- 3.08 (1.49-6.36) 0.003 -- -- Gender (male) 0.78 (0.36-1.69) 0.529 -- -- 0.68 (0.33-1.41) 0.304 -- -- B symptoms 1.26 (0.98-2.69) 0.069 -- -- 2.21 (0.88-3.94) 0.071 -- -- Figure 1. ROC curve analyses for identification of the optimal cut-off values of PET parameters predicting survival in patients with ENKTL Figure 1. ROC curve analyses for identification of the optimal cut-off values of PET parameters predicting survival in patients with ENKTL Disclosures No relevant conflicts of interest to declare.

Interim FDG PET/CT to predict progression-free survival (PFS) better than clinical and baseline metabolic measurements in Hodgkin lymphoma (cHL).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 8555-8555 ◽  
Author(s):  
Ashley Knight-Greenfield ◽  
Richard Aaron Marshall ◽  
Martin Hutchings ◽  
John Doucette ◽  
Jamie Stern ◽  
...  
Keyword(s):  
Gradient Method ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Metabolic Tumor Volume ◽  
Total Lesion Glycolysis ◽  
Interim Pet ◽  
Pet Ct ◽  
Conventional Methods ◽  
Fdg Pet Ct

8555 Background: Previous studies in cHL have demonstrated that conventional methods to risk stratify patients into various prognostic groups and predict PFS may not be sufficient to individualize therapy. Metabolic parameters using FDG-PET may be helpful for developing a prognostic algorithm and predict PFS. Objectives: To determine the best predictor of PFS among various variables of tm metabolic measurements at baseline and at interim PET/CT compared to conventional methods in cHL patients. Methods: Retrospective evaluation of prospectively acquired data in 58 cHL pts, all stages [IIB-IV:41%, >IPS-3:24%, unfavorable (UF):44%]. Eligibility: PET/CT prior to and after 1 cycle (PET1) ABVD therapy, imaging at 60min+15min, follow-up>24 mo. Baseline PET parameters including metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUVmax, and SULpeak were determined using gradient method (PETVCAR2, GE Healthcare, WI). Data were also evaluated at PET1 for %ΔMTV, %ΔSUVmax, %ΔTLG, PERCIST criteria and visually with Deauville 5-PS. Variables were correlated with PFS. Results: Median follow-up: 32.2 mo. Of 58 pts 14 relapsed (median PFS:6.5 mo). Results for PFS are displayed in the Table. No baseline conventional (stage, IPS, UF vs F) or PET variable was associated with PFS. The best predictor of PFS was Deauville 5-PS at PET1. PERCIST and %ΔTLG using gradient method trended toward significance. Conclusions: Deauville 5-PS best predicts PFS at PET1 in cHL. Neither baseline PET nor conventional prognostic factors correlated with PFS in this group of cHL pts. Risk-stratification of cHL using tumor metabolic volumetry and PERCIST criteria may require a larger sample size and further assessment of various methodologies. [Table: see text]

scholarly journals Pretreatment F-18 FDG PET/CT Parameters to Evaluate Progression-Free Survival in Gastric Cancer

2013 ◽  
Vol 48 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Jeonghun Kim ◽  
Seok Tae Lim ◽  
Chang Ju Na ◽  
Yeon-Hee Han ◽  
Chan-Young Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Free Survival ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Serum Soluble Interleukin-2 Receptor As a Surrogate Biomarker of Metabolic Tumor Volume Measured By 18F-FDG PET/CT in Diffuse Large B-Cell Lymphoma

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 345-345
Author(s):  
Hajime Senjo ◽  
Minoru Kanaya ◽  
Koh Izumiyama ◽  
Koichiro Minauchi ◽  
Kenji Hirata ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factor ◽  
Fdg Pet ◽  
Univariate Analysis ◽  
Interleukin 2 ◽  
Surrogate Marker ◽  
B Cell Lymphoma ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Background. Diffuse large B-cell lymphoma (DLBCL) is the most frequent subtype of non-Hodgkin lymphoma. High total metabolic tumor volume (TMTV) or total lesion glycolysis (TLG) calculated using 18F-FDG PET/CT images at diagnosis predicts poor prognosis of patients with DLBCL. However, high cost and poor access to the imaging facilities hamper wider use of 18F-FDG PET/CT. Methods. In order to explore a surrogate marker for TMTV/TLG, we evaluated the correlations between the serum levels of soluble interleukin-2 receptor (sIL-2R) and TMTV/TLG in 64 patients with DLBCL, and the results were verified in an independent validation cohort of 86 patients. The study procedures were in accordance with the Helsinki Declaration and institutional ethical guidelines, conducted under the auspices of the institutional ethics committee, and approved by the institutional review boards. Results. In the training cohort(n=64), OS and EFS were significantly lower in patients with TMTV≥150cm3 than in those with less than 150cm3 [5-year OS; 84.0% vs 29.1%, P=0.000194, 5-year EFS; 71.4% vs 28.7%, P=0.000384]. We also found that TLG≥1500cm3 at diagnosis predicted significantly inferior OS and EFS[5-year OS; 84.0% vs 31.7%; P=0.000477, 5-year EFS; 70.2% vs 30.6%, P=0.00107].Pearson's correlation tests demonstrated highly significant positive correlations between sIL-2R and TMTV[R2=0.490; P=0.00004] and between sIL-2R and TLG[R2=0.543; P=0.00000357]. Serum sIL-2R≥1300 U/ml was a strong prognostic factor both for worse OS and EFS[5-year OS; 85.2% vs 25.9%, P=0.000035, 5-year EFS; 72.0% vs 26.8%, P=0.000076].In a univariate analysis, B symptom, LDH, sIL-2R, TMTV and TLG were associated with poor 5-year OS; and B symptom, LDH, PS, sIL-2R, TMTV and TLG were identified as poor prognostic factors for 5-year EFS. We performed multivariate analysis that included sIL-2R and all factors in NCCN-IPI; age, LDH, clinical stage, ECOG PS and major organ involvement. In this multivariate analysis, age and sIL-2R were independently associated with poor 5-year OS(age; HR, 4.44; 95% CI, 1.05 to 18.7, P=0.0424, sIL-2R; HR, 4.45; 95% CI, 1.04 to 19.1, P=0.0444). Another multivariate analysis that included TMTV and all factors for NCCN-IPI demonstrated that TMTV was an only independent prognostic factor for 5-year OS(HR, 3.87; 95% CI, 1.08 to 13.8; log-rank, P=0.0373).Subgroup analyses included the patients with NCCN-IPI High-Int and High(n=49) demonstrated that the cut off value of TMTV 150cm3 stratified treatment outcomes in this poor prognostic group [5-year OS; 75.0% vs 27.7%, P=0.0355, 5-year EFS; 66.7% vs 29.7%, P=0.0493]. Similar results were obtained using the cut-off value of sIL-2R 1300U/mL [5-year OS; 75.0% vs 25.9%, P=0.0182, 5-year EFS; 58.3% vs 29.7%, P=0.0499]. In the validation cohort(n=86), Kaplan-Meier curves showed that OS and EFS in patients with TMTV≥150cm3 was again lower than in those with TMTV<150cm3[5-year OS; 87.0% vs 59.5%, P=0.016, 5-year EFS; 72.8% vs 52.3%, P=0.0154]. We also found that TLG≥1500 cm3 at diagnosis predicted inferior OS and EFS as TMTV did[5-year OS; 84.8% vs 59.3%, P=0.0157; log-rank, 5-year EFS; 74.8% vs 45.8%, P=0.000604]. Kaplan-Meier curves showed that sIL-2R≥1300 U/ml was a strong prognostic factor both for worse OS and EFS[5-year OS; 86.3% vs 61.8%, P=0.0188, 5-year EFS; 85.0% vs 46.8%, P=0.000413]. Pearson's correlation tests gave similar results that there were positive correlations between sIL-2R and TMTV [R2=0.461; P=0.00000631], and between sIL-2R and TLG[R2=0.720; P=0.0000017987]. In a univariate analysis, TMTV and TLG were associated with poor 5-year OS, whereas sIL-2R, TMTV and TLG were identified as poor prognostic factors for EFS. In a multivariate analysis including sIL-2R, age and sIL-2R were associated with poor 5-year OS. In another multivariate analysis including TMTV showed that age, LDH and TMTV were independent prognostic factor for 5-year OS. Altogether, we could validate the prognostic significances of sIL-2R, TMTV, and TLG, and positive correlation between sIL-2R and metabolic values, such as TMTV and TLG, confirming that sIL-2R is a surrogate biomarker of these metabolic values. Conclusion. Serum level of sIL-2R represents a convenient surrogate marker to estimate metabolic tumor burden measured by 18F-FDG PET/CT that can predict treatment outcomes of patients with DLBCL. Disclosures. No relevant conflicts of interest to declare. Figure. Figure.

6627 POSTER Preoperative F-18 FDG-PET/CT and CT Scanning Correlation in Curatively Operated Gastric Cancer Patients

2011 ◽  
Vol 47 ◽  
pp. S480
Author(s):  
J.Y. Kim ◽  
Y.R. Do ◽  
K.U. Park ◽  
H.S. Song ◽  
K.S. Won ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Ct Scanning ◽  
Pet Ct ◽  
Gastric Cancer Patients ◽  
Fdg Pet Ct

scholarly journals Radiomic Profiling of Head and Neck Cancer: 18F-FDG PET Texture Analysis as Predictor of Patient Survival

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
G. Feliciani ◽  
F. Fioroni ◽  
E. Grassi ◽  
M. Bertolini ◽  
A. Rosca ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Head And Neck ◽  
Texture Analysis ◽  
Local Control ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Local Failure ◽  
Clinical Variables ◽  
Pet Ct ◽  
Fdg Pet Ct

Background and Purpose. The accurate prediction of prognosis and pattern of failure is crucial for optimizing treatment strategies for patients with cancer, and early evidence suggests that image texture analysis has great potential in predicting outcome both in terms of local control and treatment toxicity. The aim of this study was to assess the value of pretreatment 18F-FDG PET texture analysis for the prediction of treatment failure in primary head and neck squamous cell carcinoma (HNSCC) treated with concurrent chemoradiation therapy. Methods. We performed a retrospective analysis of 90 patients diagnosed with primary HNSCC treated between January 2010 and June 2017 with concurrent chemo-radiotherapy. All patients underwent 18F-FDG PET/CT before treatment. 18F-FDG PET/CT texture features of the whole primary tumor were measured using an open-source texture analysis package. Least absolute shrinkage and selection operator (LASSO) was employed to select the features that are associated the most with clinical outcome, as progression-free survival and overall survival. We performed a univariate and multivariate analysis between all the relevant texture parameters and local failure, adjusting for age, sex, smoking, primary tumor site, and primary tumor stage. Harrell c-index was employed to score the predictive power of the multivariate cox regression models. Results. Twenty patients (22.2%) developed local failure, whereas the remaining 70 (77.8%) achieved durable local control. Multivariate analysis revealed that one feature, defined as low-intensity long-run emphasis (LILRE), was a significant predictor of outcome regardless of clinical variables (hazard ratio < 0.001, P=0.001).The multivariate model based on imaging biomarkers resulted superior in predicting local failure with a c-index of 0.76 against 0.65 of the model based on clinical variables alone. Conclusion. LILRE, evaluated on pretreatment 18F-FDG PET/CT, is associated with higher local failure in patients with HNSCC treated with chemoradiotherapy. Using texture analysis in addition to clinical variables may be useful in predicting local control.

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