Therapy Response Evaluation With Fdg-Pet/Ct In Thoracic Malignancies

Objective: To determine the prevalence of abdominal involvement, distribution pattern and evaluate role of hybrid molecular imaging in patients with abdominal sarcoidosis. Methods: Between January 2010 and December 2011, 98 patients with chronic sarcoidosis and presence of prolonged symptoms or other findings suggestive of active disease were referred to FDG PET/CT examination. Active disease was found in 82 patients, and they all were screened for the presence of abdominal sarcoidosis on FDG PET/CT. All patients also underwent MDCT and assessment of serum ACE level. Follow up FDG PET/CT examination was done 12.3±5.4 months after the baseline. Results: Abdominal sarcoidosis was present in 31/82 patients with active sarcoidosis. FDG uptake was present in: retroperitoneal lymph nodes (77%), liver (26%), spleen (23%), adrenal gland (3%). Majority of patients had more than two locations of disease. Usually thoracic disease was spread into the extrathoracic localizations, while isolated abdominal sarcoidosis was present in 10% of patients. After first FDG PET/CT examination therapy was changed in all patients. Eleven patients came to the follow up examination where SUVmax significantly decreased in the majority of them. Three patients had total remission, three had absence of abdominal disease but discrete findings in thorax and others had less spread disease. ACE levels did not correlate with SUVmax level. Conclusion: FDG PET/CT can be a useful tool for detection of abdominal sarcoidosis and in the evaluation of therapy response in these patients. Awareness of the presence of intra-abdominal sarcoidosis is important in order to prevent long-standing unrecognized disease.

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Tumor response evaluation in patients with malignant melanoma undergoing immune checkpoint inhibitor therapy and prognosis prediction using 18F-FDG PET/CT: multicenter study for comparison of EORTC, PERCIST, and imPERCIST

Japanese Journal of Radiology ◽

10.1007/s11604-021-01174-w ◽

2021 ◽

Author(s):

Kazuhiro Kitajima ◽

Tadashi Watabe ◽

Masatoyo Nakajo ◽

Mana Ishibashi ◽

Hiromitsu Daisaki ◽

...

Keyword(s):

Metabolic Disease ◽

Malignant Melanoma ◽

Fdg Pet ◽

Immune Checkpoint Inhibitor ◽

Metabolic Response ◽

Checkpoint Inhibitor ◽

Response Evaluation ◽

Pet Ct ◽

Melanoma Patients ◽

Fdg Pet Ct

Abstract Objective In malignant melanoma patients treated with immune checkpoint inhibitor (ICI) therapy, three different FDG-PET criteria, European Organization for Research and Treatment of Cancer (EORTC), PET Response Criteria in Solid Tumors (PERCIST), immunotherapy-modified PERCIST (imPERCIST), were compared regarding response evaluation and prognosis prediction using standardized uptake value (SUV) harmonization of results obtained with various PET/CT scanners installed at different centers. Materials and methods Malignant melanoma patients (n = 27) underwent FDG-PET/CT examinations before and again 3 to 9 months after therapy initiation (nivolumab, n = 21; pembrolizumab, n = 6) with different PET scanners at five hospitals. EORTC, PERCIST, and imPERCIST criteria were used to evaluate therapeutic response, then concordance of the results was assessed using Cohen’s κ coefficient. Log-rank and Cox methods were employed to determine progression-free (PFS) and overall (OS) survival. Results Complete metabolic response (CMR)/partial metabolic response (PMR)/stable metabolic disease (SMD)/progressive metabolic disease (PMD) with harmonized EORTC, PERCIST, and imPERCIST was seen in 3/5/4/15, 4/5/3/15, and 4/5/5/13 patients, respectively. Nearly perfect concordance between each pair of criteria was noted (κ = 0.939–0.972). Twenty patients showed progression and 14 died from malignant melanoma after a median 19.2 months. Responders (CMR/PMR) showed significantly longer PFS and OS than non-responders (SMD/PMD) (harmonized EORTC: p < 0.0001 and p = 0.011; harmonized PERCIST: p < 0.0001 and p = 0.0012; harmonized imPERCIST: p < 0.0001 and p = 0.0012, respectively). Conclusions All harmonized FDG-PET criteria (EORTC, PERCIST, imPERCIST) showed accuracy for response evaluation of ICI therapy and prediction of malignant melanoma patient prognosis. Additional studies to determine their value in larger study populations will be necessary.

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323P The role of SUVmax in 18F-FDG PET/CT for assessing radiation therapy response for cervical cancer

Annals of Oncology ◽

10.1093/annonc/mdw585.027 ◽

2016 ◽

Vol 27 (suppl_9) ◽

Author(s):

S.H. Lee ◽

K.C. Lee ◽

K. Sung ◽

E.Y. Choi ◽

J.B. Bae ◽

...

Keyword(s):

Cervical Cancer ◽

Radiation Therapy ◽

Fdg Pet ◽

Therapy Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Potential role of [18F]FDG-PET/CT in the evaluation of therapy response after neoadjuvant chemotherapy

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(06)80400-3 ◽

2006 ◽

Vol 4 (2) ◽

pp. 159

Author(s):

I. Segaert ◽

Neven ◽

S. Stroobants ◽

M. Drijkoningen ◽

F. Amant ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Fdg Pet ◽

Potential Role ◽

Therapy Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Reply: Qualitative 18F-FDG PET/CT Response Evaluation After Chemotherapy or Radiotherapy for Head and Neck Squamous Cell Carcinoma: Is There an Equivocal Group?

Journal of Nuclear Medicine ◽

10.2967/jnumed.114.148379 ◽

2014 ◽

Vol 55 (12) ◽

pp. 2081-2082 ◽

Cited By ~ 1

Author(s):

R. M. Subramaniam

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Fdg Pet ◽

Neck Squamous Cell Carcinoma ◽

Response Evaluation ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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18F-FDG PET/CT in Treatment Response Evaluation in Thyroid Cancer

Atlas of Clinical PET-CT in Treatment Response Evaluation in Oncology ◽

10.1007/978-3-030-68858-5_26 ◽

2021 ◽

pp. 439-451

Author(s):

Fahim Ul Hassan ◽

Haseeb Ahmed

Keyword(s):

Thyroid Cancer ◽

Treatment Response ◽

Fdg Pet ◽

Response Evaluation ◽

Treatment Response Evaluation ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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18F-FDG Pet Parameters and Radiomics Features Analysis in Advanced Nsclc Treated with Immunotherapy as Predictors of Therapy Response and Survival

Cancers ◽

10.3390/cancers12051163 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1163 ◽

Cited By ~ 4

Author(s):

Giulia Polverari ◽

Francesco Ceci ◽

Valentina Bertaglia ◽

Maria Lucia Reale ◽

Osvaldo Rampado ◽

...

Keyword(s):

Disease Progression ◽

Fdg Pet ◽

Tumor Volume ◽

Advanced Nsclc ◽

Therapy Response ◽

Primary Lesion ◽

Line Therapy ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Objectives: (1.1) to evaluate the association between baseline 18F-FDG PET/CT semi-quantitative parameters of the primary lesion with progression free survival (PFS), overall survival (OS) and response to immunotherapy, in advanced non-small cell lung carcinoma (NSCLC) patients eligible for immunotherapy; (1.2) to evaluate the application of radiomics analysis of the primary lesion to identify features predictive of response to immunotherapy; (1.3) to evaluate if tumor burden assessed by 18F-FDG PET/CT (N and M factors) is associated with PFS and OS. Materials and Methods: we retrospectively analyzed clinical records of advanced NCSLC patients (stage IIIb/c or stage IV) candidate to immunotherapy who performed 18F-FDG PET/CT before treatment to stage the disease. Fifty-seven (57) patients were included in the analysis (F:M 17:40; median age = 69 years old). Notably, 38/57 of patients had adenocarcinoma (AC), 10/57 squamous cell carcinoma (SCC) and 9/57 were not otherwise specified (NOS). Overall, 47.4% patients were stage IVA, 42.1% IVB and 8.8% IIIB. Immunotherapy was performed as front-line therapy in 42/57 patients and as second line therapy after chemotherapy platinum-based in 15/57. The median follow up after starting immunotherapy was 10 months (range: 1.5–68.6). Therapy response was assessed by RECIST 1.1 criteria (CT evaluation every 4 cycles of therapy) in 48/57 patients or when not feasible by clinical and laboratory data (fast disease progression or worsening of patient clinical condition in nine patients). Radiomics analysis was performed by applying regions of interest (ROIs) of the primary tumor delineated manually by two operators and semi-automatically applying a threshold at 40% of SUVmax. Results: (1.1) metabolic tumor volume (MTV) (p = 0.028) and total lesion glycolysis (TLG) (p = 0.035) were significantly associated with progressive vs. non-progressive disease status. Patients with higher values of MTV and TLG had higher probability of disease progression, compared to those patients presenting with lower values. SUVmax did not show correlation with PD status, PFS and OS. MTV (p = 0.027) and TLG (p = 0.022) also resulted in being significantly different among PR, SD and PD groups, while SUVmax was confirmed to not be associated with response to therapy (p = 0.427). (1.2) We observed the association of several radiomics features with PD status. Namely, patients with high tumor volume, TLG and heterogeneity expressed by “skewness” and “kurtosis” had a higher probability of failing immunotherapy. (1.3) M status at 18F-FDG PET/CT was significantly associated with PFS (p = 0.002) and OS (p = 0.049). No significant associations were observed for N status. Conclusions: 18F-FDG PET/CT performed before the start of immunotherapy might be an important prognostic tool able to predict the disease progression and response to immunotherapy in patients with advanced NSCLC, since MTV, TLG and radiomics features (volume and heterogeneity) are associated with disease progression.

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