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.

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]

Development and validation of a prognostic score for overall survival integrating baseline metabolically active tumor volume measured by 18F-FDG PET/CT and clinical factors for metastatic colorectal cancer patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3543-3543
Author(s):  
Erwin Woff ◽  
Alain Hendlisz ◽  
Lisa Salvatore ◽  
Federica Marmorino ◽  
Alfredo Falcone ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Fdg Pet ◽  
Tumor Volume ◽  
Prognostic Score ◽  
Risk Groups ◽  
Clinical Factors ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Development And Validation

3543 Background: This study aimed to develop and validate a prognostic score integrating baseline metabolically active tumor volume (MATV) and clinical factors in metastatic colorectal cancer (mCRC) patients. Methods: The development cohort included chemorefractory mCRC patients enrolled in two prospective multicenter non-randomized trials evaluating sorafenib/regorafenib as last line therapy. The validation cohort included mCRC patients from another center, treated with chemotherapy and bevacizumab as first line. Baseline MATV was defined as the sum of metabolically active volumes of all target lesions identified on the baseline 18F-FDG PET/CT. MATV optimal cutoff for OS prediction was determined from the development cohort with Contal and O’Quigley’s method. MATV, age, gender, BMI, ECOG PS, years since diagnosis, and KRAS status were included in a multivariate analysis. A prognostic score to predict OS was developed from the development cohort using Cox proportional hazards model. Results: MATV and clinical factors were evaluable respectively in 155 and 122 patients of the development and validation cohorts. In univariate analysis, MATV with cutoff set at 100 cm³ identified two risk groups with different median OS (mOS) in both the development (4.5 vs 10.9 months, HR: 2.64; p < 0.001) and validation cohorts (20.9 vs 42.9 months, HR: 2.39; p < 0.001). A multivariate analysis identified four independent negative predictors of OS (high MATV, short time since diagnosis, poor PS, BMI < 25). Combining these factors in a prognostic score for OS (best cutoff:-2) allowed to identify two risk groups with different mOS in the development (4.4 vs 13.4 months, HR: 3.67; p < 0.001) and validation cohorts (25 vs 63.8 months, HR: 2.5; p = 0.001). Conclusions: In mCRC patients, the high prognostic value of baseline MATV found in the development cohort was confirmed by external validation, independently of patients’ treatment. In both the development and validation cohorts the prognostic score for OS allowed to identify two risk groups of mCRC patients with significantly different mOS. MATV and our prognostic score for OS should provide a firm basis for risk stratification, in clinical practice and research trials.

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.

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.

scholarly journals Positron Emission Tomography for the Response Evaluation following Treatment with Chemotherapy in Patients Affected by Colorectal Liver Metastases: A Selected Review

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto Zaniboni ◽  
Giordano Savelli ◽  
Claudio Pizzocaro ◽  
Pietro Basile ◽  
Valentina Massetti
Keyword(s):  
Liver Metastases ◽  
Fdg Pet ◽  
Therapy Response ◽  
Progression Free Survival ◽  
Free Survival ◽  
Positron Emission ◽  
Response To Chemotherapy ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Ct And Mri

The aim of the present paper is to review the scientific literature concerning the usefulness of18F-FDG PET/CT in the evaluation of response to chemotherapy in patients affected by liver metastases from colorectal cancer.Material and Methods. Studies were identified by searching PubMed electronic databases. Both prospective and retrospective studies were included. Information regarding the figure of merit of PET for the evaluation of therapy response was extracted and analyzed.Results. Existing data suggests that18F-FDG PET/CT may have an outstanding role in evaluating the response. The sensitivity of PET in detecting therapy response seems to be greater than conventional imaging (CT and MRI). PET/CT response is strictly related to better overall survival and progression-free survival.Conclusions. PET/CT is more than a promising technique to assess the response to chemotherapy in colorectal and liver metastases. However, to be fully validated, this examination needs further studies by recruiting more patients.

FDG-PET/CT is Predictive of Progression-free Survival in Anal Cancer

2009 ◽  
Vol 75 (3) ◽  
pp. S258-S259
Author(s):  
W.W. Lien ◽  
A.R. Rao ◽  
J.S. Kaptein ◽  
M.A. Tome
Keyword(s):  
Anal Cancer ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Free Survival ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Post-transplantation Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Lymphoblastic Lymphoma is an Independent Prognostic Factor with an Impact on Progression-Free Survival but not Overall Survival

2021 ◽  
Vol 20 ◽  
pp. 153303382110564
Author(s):  
Na Dai ◽  
Hang Liu ◽  
Shengming Deng ◽  
Shibiao Sang ◽  
Yiwei Wu
Keyword(s):  
Prognostic Factor ◽  
Fdg Pet ◽  
Progression Free Survival ◽  
Lymphoblastic Lymphoma ◽  
Emission Tomography ◽  
Free Survival ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose: In the present study, we mainly aimed to evaluate the prognostic value of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET)/computed tomography (CT) after allogeneic stem cell transplantation (allo-SCT) in lymphoblastic lymphoma (LBL) patients using Deauville Scores (DS). Materials and Methods: A total of 63 LBL patients who benefited from 18F-FDG PET-CT after allo-SCT in our institution between April 2010 and August 2020 were enrolled in this retrospective study. These above-mentioned patients were divided into two groups based on the Deauville criteria. Diagnostic efficiency of 18F-FDG PET/CT and integrated CT in detecting lymphoma were calculated. Consistencies were evaluated by comparing 18F-FDG PET/CT and integrated CT results through kappa coefficient. Kaplan-Meier method was used in survival analysis, and the log-rank method was adopted in comparisons. Prognostic factor analysis was performed by the Cox regression model. Results: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of post-SCT 18F-FDG PET-CT were 100%(12/12), 92.2%(47/51), 75.0%(12/16), 100%(47/47) and 93.7%(59/63). The consistency of 18F-FDG PET-CT and integrated CT was moderate(Kappa = .702，P < .001). Positive post-SCT 18F-FDG PET-CT was associated with lower progression-free survival (PFS) but not overall survival (OS) (p = .000 and p = .056, respectively). The 3-year PFS of the PET-positive group and PET-negative group was 18.8% and 70.2%, respectively. Multivariate analysis showed that post-SCT PET-CT findings was an independent prognostic factor for PFS (p = .000; HR, 3.957; 95%CI, 1.839-8.514). Other factors independently affecting PFS were sex (p = .018; HR, 2.588; 95% CI, 1.181 − 5.670) and lactate dehydrogenase (LDH) (p = .005; HR, 3.246; 95% CI, 1.419 − 7.426). However, none of the above-mentioned factors were associated with OS. Conclusions: Collectively, we found that 18F-FDG PET-CT after allo-SCT was a strong indicator for PFS, but not OS, which might provide important evidence for the selection of subsequent treatment regimen for LBL patients. Trial registration number: ChiCTR2100046709.

scholarly journals Prognostic value of the baseline 18F-FDG PET/CT metabolic tumour volume (MTV) and further stratification in low-intermediate (L-I) and high-intermediate (H-I) risk NCCNIPI subgroup by MTV in DLBCL MTV predict prognosis in DLBCL

2020 ◽  
Author(s):  
Peng Zhao ◽  
Tao Yu ◽  
Zheng Pan
Keyword(s):  
Risk Stratification ◽  
Fdg Pet ◽  
Prognostic Value ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Metabolic Parameters ◽  
Metabolic Tumour Volume ◽  
P Value ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Introduction In the era of rituximab, the NCCNIPI is widely used in clinical practice as a tool for the prognosis and risk stratification of diffuse large B-cell lymphoma (DLBCL). In recent years, FDG PET/CT has also shown unique prognostic value. We try to further confirm the prognostic role of metabolic parameters in the overall and subgroups patients. Methods We retrospectively analysed 87 DLBCL patients who underwent baseline FDG PET/CT and followed the R-CHOP or R-CHOP-like strategy. The clinical parameters and PET-related metabolic parameters were evaluated. Results For all patients, the 2-year PFS rate was 65.5% and the 2-year OS rate was 66.7%. According to Cox multivariate analysis, a high NCCNIPI score (4–8 points) and an MTV greater than 64.1 cm3 (defined by ROC) were independent prognostic factors for PFS and OS. The patients were divided into low, low-intermediate, high-intermediate and high-risk groups by NCCNIPI score. The 2-year PFS rates in each group were 90.9%, 71.3%, 33.2% and 16.7%, and the 2-year OS rates were 100%, 81.6%, 48.4% and 16.7%. In the subsequent subgroup analysis by MTV, it could further stratified low-intermediate and high-intermediate NCCNIPI groups, the P value was 0.068 and 0.069 for PFS, 0.078 and 0.036 for OS. Conclusions MTV, as a tumor metabolic volume parameter, and the NCCNIPI score were independent predictors of prognosis in general DLBCL patients. In the low-intermediate and high-intermediate NCCNIPI subgroup, we further confirm the risk stratification abilities of MTV, which could add the prognostic value of NCCNIPI.

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