scholarly journals 18F-FDG PET/CT and Urothelial Carcinoma: Impact on Management and Prognosis—A Multicenter Retrospective Study

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 700 ◽  
Author(s):  
Fabio Zattoni ◽  
Elena Incerti ◽  
Fabrizio Dal Moro ◽  
Marco Moschini ◽  
Paolo Castellucci ◽  
...  
Keyword(s):  
Overall Survival ◽  
Urothelial Carcinoma ◽  
Fdg Pet ◽  
Patient Management ◽  
Survival Prediction ◽  
Primary Tumor Site ◽  
Kaplan Meier ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Objectives: To evaluate the ability of 18F-labeled fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to predict survivorship of patients with bladder cancer (BC) and/or upper urinary tract carcinoma (UUTC). Materials: Data from patients who underwent FDG PET/CT for suspicion of recurrent urothelial carcinoma (UC) between 2007 and 2015 were retrospectively collected in a multicenter study. Disease management after the introduction of FDG PET/CT in the diagnostic algorithm was assessed in all patients. Kaplan-Meier and log-rank analysis were computed for survival assessment. A Cox regression analysis was used to identify predictors of recurrence and death, for BC, UUTC, and concomitant BC and UUTC. Results: Data from 286 patients were collected. Of these, 212 had a history of BC, 38 of UUTC and 36 of concomitant BC and UUTC. Patient management was changed in 114/286 (40%) UC patients with the inclusion of FDG PET/CT, particularly in those with BC, reaching 74% (n = 90/122). After a mean follow-up period of 21 months (Interquartile range: 4–28 mo.), 136 patients (47.4%) had recurrence/progression of disease. Moreover, 131 subjects (45.6%) died. At Kaplan-Meier analyses, patients with BC and positive PET/CT had a worse overall survival than those with a negative scan (log-rank < 0.001). Furthermore, a negative PET/CT scan was associated with a lower recurrence rate than a positive examination, independently from the primary tumor site. At multivariate analysis, in patients with BC and UUTC, a positive FDG PET/CT resulted an independent predictor of disease-free and overall survival (p < 0,01). Conclusions: FDG PET/CT has the potential to change patient management, particularly for patients with BC. Furthermore, it can be considered a valid survival prediction tool after primary treatment in patients with recurrent UC. However, a firm recommendation cannot be made yet. Further prospective studies are necessary to confirm our findings.

scholarly journals Long-Term Survival and Value of 18F-FDG PET/CT in Patients with Gastroenteropancreatic Neuroendocrine Tumors Treated with Second Peptide Receptor Radionuclide Therapy Course with 177Lu-DOTATATE

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 198
Author(s):  
Margarida Rodrigues ◽  
Kevin-Klaus Winkler ◽  
Hanna Svirydenka ◽  
Bernhard Nilica ◽  
Christian Uprimny ◽  
...  
Keyword(s):  
Overall Survival ◽  
Fdg Pet ◽  
Median Overall Survival ◽  
Peptide Receptor Radionuclide Therapy ◽  
Term Survival ◽  
Peptide Receptor ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Peptide receptor radionuclide therapy (PRRT) has been recognized as a promising therapy against neuroendocrine tumors (NETs). The use of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in NETs has been a matter of controversy. The purpose of this study was to evaluate the long-term survival and efficacy of a second PRRT course with 177Lu-DOTATE in patients with advanced gastroenteropancreatic (GEP) NETs. Furthermore, the value of 18F-FDG PET/CT in these patients was evaluated. 40 patients with GEP NETs who underwent two PRRT courses with 177Lu-DOTATATE and combined examinations with 68Ga-DOTA-TOC and 18F-FDG PET/CT were evaluated. After the second PRRT course, two patients (5.0%) were in partial remission, 21 patients (52.5%) in stable disease and 17 patients (42.5%) had progressive disease. The median overall survival was 122.10 months. After the second PRRT course, the median overall survival was significantly higher (p = 0.033) in the 18F-FDG-negative group compared to the 18F-FDG-positive group (145.50 versus 95.06 months, respectively). The median time to progression was 19.37 months. In conclusion, a second PRRT course with 177Lu-DOTATE is an effective treatment approach for GEP NET patients with disease progression. A change in 18F-FDG status after PRRT may predict the disease course and survival. Patients who are 18F-FDG-negative have a significantly longer overall survival than those who are 18F-FDG-positive.

scholarly journals NGHIÊN CỨU VAI TRÒ TIÊN LƯỢNG CỦA GIÁ TRỊ HẤP THU CHUẨN 18F-FDG PET/CT Ở BỆNH NHÂN UNG THƯ BIỂU MÔ VẢY THỰC QUẢN ĐIỀU TRỊ HOÁ - XẠ TRIỆT CĂN

2021 ◽  
Vol 506 (1) ◽  
Author(s):  
Nguyễn Đình Châu ◽  
Lê Ngọc Hà
Keyword(s):  
Fdg Pet ◽  
Kaplan Meier ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Mục tiêu: Xác định vai trò các giá trị hấp thu chuẩn của 18F-FDG PET/CT trước điều trị trong tiên lượng kết quả hóa – xạ triệt căn ở bệnh nhân ung thư biểu mô vảy thực quản. Đối tượng và phương pháp: Nghiên cứu can thiệp, tiến cứu trên 60 bệnh nhân ung thư biểu mô vảy thực quản 1/3 trên được chụp 18F-FDG PET/CT đánh giá giai đoạn trước điều trị và chỉ định hoá xạ trị triệt căn. Các giá trị hấp thu chuẩn 18F-FDG của khối u bao gồm SUVmax, SUVmean, SUVpeak. Sử dụng đường cong ROC để đánh giá ngưỡng SUV tối ưu liên quan tới đáp ứng và sống thêm. Phân tích đường cong Kaplan-Meier để ước tính sống thêm toàn bộ và sống thêm bệnh không tiến triển. Phân tích hồi quy Cox để tìm biến tiên lượng độc lập với sống thêm. Kết quả: BN có đáp ứng hoàn toàn chiếm 38,3%. Tỷ lệ sống thêm toàn bộ và sống thêm bệnh không tiến triển 4 năm lần lượt là 48,6% và 44,4 %. SUVmean u tại ngưỡng 6,1 có giá trị dự báo đáp ứng hoàn toàn với độ nhạy 69,6%, độ đặc hiệu 78,4%, độ chính xác 75%. SUVmean u > 6,1 là yếu tố tiên lượng độc lập không thuận lợi cho sống thêm toàn bộ (HR = 6,74, p = 0,02) và sống thêm bệnh không tiến triển (HR = 6,53, p = 0,00). Kết luận: Thông số SUVmean của u nguyên phát trên 18F-FDG PET/CT trước điều trị có thể sử dụng để tiên lượng kết quả điều trị ở bệnh nhân ung thư biểu mô vảy thực quản sau hoá - xạ trị triệt căn.

Initial [18F]FDG PET/CT in high-risk DTC patients

2016 ◽  
Vol 55 (03) ◽  
pp. 99-103 ◽  
Author(s):  
Ina Binse ◽  
Andreas Bockisch ◽  
Sandra Rosenbaum-Krumme ◽  
Marcus Ruhlmann
Keyword(s):  
High Risk ◽  
Fdg Pet ◽  
Patient Management ◽  
Whole Body ◽  
Prognostic Impact ◽  
Full Remission ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryIn a previous paper, we published the impact of initial [18F]FDG PET/CT (FDG-PET/CT) in high-risk patients with differentiated thyroid cancer (DTC) and described the changes in therapy management. The aim of the present study was to evaluate the prognostic impact of the initial FDG-PET/CT on a patient’s follow-up over three years and the rate of complete remission. Patients, methods: This study included 109 DTC patients who underwent radioiodine treatment (RIT), including posttherapeutic whole-body scintigraphy with FDG-PET/CT and a follow-up over three years. The follow-up included high-resolution sonography of the neck and determination of serum Tg as well as Tg antibodies every six months. The results of initial FDG-PET/CT and whole-body scintigraphy were compared with the status after three years of follow-up. Results: 24/109 patients (22%) presented FDG-positive lesions, 22/109 patients (20%) only iodine-positive lesions, and 63/109 patients (58%) neither FDG-positive nor iodine-positive lesions. After three years, 83/109 patients (76%) revealed full remission, 15/109 patients (14%) tumour persistence and 11/109 patients (10%) a progressive disease. The negative predictive value (NPV) was calculated for patients without FDG-positive lesions (NPV 85%) and patients without any lesions (NPV 91%) regarding full remission in the follow-up. Conclusion: FDG-PET/CT has a high NPV (85% to 91%) in DTC patients regarding recurrence-free follow-up after three years. The change in patient management in patients with iodine-negative lesions can lead to a higher rate of full remissions in the follow-up after additional surgery. Therefore, FDG-PET/ CT should be performed in all high-risk DTC patients in the context of the first RIT to improve patient management and risk stratification.

scholarly journals Impact of an 18F-FDG PET/CT Radiotracer Injection Infiltration on Patient Management—A Case Report

2018 ◽  
Vol 5 ◽  
Author(s):  
Jackson W. Kiser ◽  
James R. Crowley ◽  
David A. Wyatt ◽  
Ronald K. Lattanze
Keyword(s):  
Case Report ◽  
Fdg Pet ◽  
Patient Management ◽  
Pet Ct ◽  
Radiotracer Injection ◽  
18F Fdg ◽  
Fdg Pet Ct

FA06.05: DETECTING RESIDUAL ESOPHAGEAL CANCER AFTER NEOADJUVANT CHEMORADIATION BY ENDOSCOPIC BIOPSIES, EUS AND FDG-PET: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 12-13
Author(s):  
B Eyck ◽  
B Noordman ◽  
B Onstenk ◽  
Daan Nieboer ◽  
M C W Spaander ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Fdg Pet ◽  
Residual Disease ◽  
Meta Analysis ◽  
Primary Tumor Site ◽  
Endoscopic Biopsies ◽  
Pet Ct ◽  
Subgroup Analyses ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Background After curatively intended neoadjuvant chemoradiotherapy (nCRT) according to CROSS plus surgery for esophageal cancer, 29% of patients have a pathologic complete response. Active surveillance after nCRT, in which patients undergo frequent clinical examinations and where esophagectomy is only offered to those with a locoregional regrowth without distant metastases, has been proposed as novel treatment option. This study provides a systematic review and meta-analysis of the literature regarding the accuracy of endoscopic biopsies, endoscopic ultrasound (EUS) and 18F-FDG PET(-CT) for detecting residual disease after nCRT for esophageal cancer. Methods A systematic literature search in Embase, Medline, Cochrane and Web of Science was performed. Two reviewers independently collected studies on the diagnostic accuracy of endoscopic biopsies, EUS and 18F-FDG PET(-CT) for detecting residual disease after nCRT at the primary tumor site or in regional lymph nodes for potentially curable esophageal adenocarcinoma (AC) or squamous cell carcinoma (SCC). Histopathological examination of the resection specimen was the reference standard. Study quality was appraised with the QUADAS-2 tool. Sensitivity and specificity values were calculated and pooled using meta-analyses. Subgroup analyses were performed to investigate possible sources of heterogeneity. Results 60 studies were included for qualitative analysis and 40 for quantitative analysis. For detecting residual disease at the primary tumor site, 11 studies evaluated endoscopic biopsies, 11 described EUS qualitatively, 14 evaluated PET qualitatively, 12 evaluated PET quantitatively, 6 of them using SUVmax and 6 of them using DSUVmax. Summary sensitivity values were 0.36 (95%CI 0.27–0.45), 0.97 (95%CI 0.94–0.98), 0.74 (95%CI 0.66–0.81), 0.68 (95%CI 0.61–0.74) and 0.68 (95%CI 0.54–0.79), respectively. Summary specificity values were 0.93 (95%CI 0.85–0.97), 0.09 (95%CI 0.04–0.19), 0.52 (95%CI 0.40–0.63), 0.70 (95%CI 0.61–0.78), 0.70 (95%CI 0.60–0.78) and respectively. For detecting residual malignant lymph nodes, 11 studies evaluated EUS with a summary sensitivity of 0.68 (95%CI 0.54–0.80) and a summary specificity of 0.58 (95%CI 0.45–0.70). Subgroup analyses demonstrated that sensitivity of endoscopic biopsy, PET DSUVmax and EUS for nodal was higher in SCC than in AC. Conclusion Current literature suggests insufficient accuracy of endoscopic biopsies, EUS and 18F-FDG PET(-CT) as individual modalities for detecting residual disease after nCRT for potentially curable esophageal cancer. Disclosure All authors have declared no conflicts of interest.

scholarly journals Addition of 18F-FDG PET/CT to Clinical Assessment Predicts Overall Survival in HNSCC: A Retrospective Analysis with Follow-up for 12 Years

2013 ◽  
Vol 54 (12) ◽  
pp. 2039-2045 ◽  
Author(s):  
V. Paidpally ◽  
A. K. Tahari ◽  
S. Lam ◽  
K. Alluri ◽  
S. Marur ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Analysis ◽  
Clinical Assessment ◽  
Fdg Pet ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Survival in patients with hepatocellular carcinoma treated with 90Y-microsphere radioembolization

2014 ◽  
Vol 53 (02) ◽  
pp. 39-45 ◽  
Author(s):  
A. Sabet ◽  
H. Ahmadzadehfar ◽  
J. Bruhman ◽  
A. Sabet ◽  
C. Meyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Fdg Pet ◽  
Metabolic Response ◽  
Performance Status ◽  
Rank Test ◽  
Study Cohort ◽  
Kaplan Meier ◽  
Pet Ct ◽  
Fdg Pet Ct

SummaryAim: This retrospective study aims to evaluate the predictive value of FDG PET/CT in patients with unresectable hepatocellular carcinoma (HCC) undergoing radioembolization with yttrium-90 labeled microspheres (RE). Patients, methods: The study cohort comprised 33 patients who were treated with RE at our institution and underwent FDG PET/CT at baseline and four weeks after radioembolization. According to the baseline FDG metabolic status of the HCC lesions, patients were divided into two groups: FDG-negative (n = 12) and FDG-positive (n = 21) HCC. FDG-positive patients were further divided into early metabolic responders and non-re- sponders according to the relative change in SUVmax of the treated lesions. Survival analyses were performed with the Kaplan-Meier method (log-rank test, p < 0.05). Multivariate analysis was performed to assess the influence of prognostic factors on overall survival (OS). Results: FDG-negative patients had a significantly longer OS (13 months, 95%CI 7-19) than FDG-positive patients (9 months, 95%CI 7-11; p = 0.010). Among FDG- positive patients, metabolic responders survived significantly longer than metabolic non- responders (10 months, 95%CI 8-12 vs. 5 months, 95%CI 4-6; p = 0.003). From the other baseline factors (including performance status, hepatic tumour burden, presence of extra-hepatic disease, administered activity) only the BCLC stage had a significant impact on OS (p = 0.028). Conclusion: Pre- and post- therapeutic FDG PET independently predicts overall survival in patients with HCC undergoing radioembolization. Interestingly, early metabolic response seems to be assessable as early as four weeks post-treatment.

Sign in / Sign up

Export Citation Format

Share Document