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Evaluation of third treatment week as temporal window for assessing responsiveness on repeated FDG-PET scans in Non-Small Cell Lung Cancer patients
Karolinska Institutet.ORCID iD: 0000-0001-6676-508X
RaySearch Laboratories AB.
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2018 (English)In: Physica medica (Testo stampato), ISSN 1120-1797, E-ISSN 1724-191X, Vol. 46, p. 45-51Article in journal (Refereed) Published
Abstract [en]

Purpose: Early assessment of tumour response to treatment with repeated FDG-PET-CT imaging has potential fortreatment adaptation but it is unclear what the optimal time window for this evaluation is. Previous studiesindicate that changes in SUVmeanand the effective radiosensitivity (αeff, accounting for uptake variations andaccumulated dose until the second FDG-PET-CT scan) are predictive of 2-year overall survival (OS) whenimaging is performed before radiotherapy and during the second week. This study aims to investigate if multipleFDG-PET-derived quantities determined during the third treatment week have stronger predictive power.

Methods: Twenty-eight lung cancer patients were imaged with FDG-PET-CT before radiotherapy (PET1) andduring the third week (PET2). SUVmean, SUVmax, SUVpeak, MTV41%–50% (Metabolic Tumour Volume),TLG41%–50% (Total Lesion Glycolysis) in PET1 and PET2 and their change (), as well as averageαeff(αeff) andthe negative fraction ofαeffvalues<f(αeff0) were determined. Correlations were sought between FDG-PET-de-rived quantities and OS with ROC analysis.

Results: Neither SUVmean, SUVmax, SUVpeakin PET1 and PET2 (AUC = 0.5–0.6), nor their changes(AUC = 0.5–0.6) were significant for outcome prediction purposes. Lack of correlation with OS was also foundforαeff(AUC = 0.5) and<fαeff0(AUC = 0.5). Threshold-based quantities (MTV41%–50%, TLG41%–50%) andtheir changes had AUC = 0.5–0.7.P-values were in all cases≫0.05.

Conclusions: The poor OS predictive power of the quantities determined from repeated FDG-PET-CT imagesindicates that the third week of treatment might not be suitable for treatment response assessment.Comparatively, the second week during the treatment appears to be a better time window.

Place, publisher, year, edition, pages
2018. Vol. 46, p. 45-51
Keyword [en]
FDG-PET-CT, NSCLC, Treatment adaptation
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:su:diva-153705DOI: 10.1016/j.ejmp.2018.01.012OAI: oai:DiVA.org:su-153705DiVA, id: diva2:1187709
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-03-31Bibliographically approved

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Lazzeroni, MartaDasu, AlexandruToma-Dasu, Iuliana
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