Laetitia Padovani1,2, Aurelie Baret2, Joseph Ciccolini1, David Taieb3, Farman Bardia3, Laetitia Teissonnier3, Xavier Muracciole1,2, Fabrice Barlesi1,4, Dominique Barbolosi1. 1. 1 SMARTc, INSERM, UMR 911 CRO2, Aix Marseille Université, Marseille, France. 2. 2 Assistance Publique des Hôpitaux de Marseille, Radiotherapy Department, Marseille, France. 3. 3 Aix Marseille Université; Assistance Publique Hôpitaux de Marseille, Nuclear Medical Department, Marseille, France. 4. 4 Aix Marseille Université; Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Marseille, France.
Abstract
OBJECTIVE: Positron emission tomography with (18)F fludeoxyglucose integrated with CT ((18)F-FDG PET/CT) is a recommended imaging procedure in the evaluation of non-small-cell lung cancers (NSCLCs). Radiochemotherapy (RCT) is a mainstay for treatment of locally advanced NSCLC, for which overall survival still remains poor. Early evaluation of treatment response may help in decision-making to complete radiotherapy (RT) or to switch to other treatment modalities. The present study aimed to evaluate the performance of new metabolic parameters based on a simplified kinetic analysis on a single time point (SKA-S)-derived mathematical method, as compared with standardized uptake value (SUV) measurement during RT. METHODS: Four patients treated with RT or RCT for NSCLC were evaluated using (18)F-FDG PET/CT during RT and after treatment completion. Whole-body (18)F-FDG PET/CT was performed followed by four additional list-mode acquisitions centered over the target lesion. Response was evaluated at four times (i.e. PET1-PET4) by calculating standard SUV values and T80%, the time taken to reach 80% of (18)F-FDG metabolized fraction using a SKA-S-derived mathematical method. RESULTS: Data from SUV and T80% calculations were found to be controversial. T80% was found to be more predictive of clinical outcome. CONCLUSION: Although results from this pilot study should be further confirmed in a large prospective study, the data suggest that T80% is a promising metabolic biomarker for assessing early response to RT. ADVANCES IN KNOWLEDGE: In this proof of concept study, we show that T80% defined from a mathematic model taking into account the net influx rate constant and vascular volume could be consider as a promising biomarker as compared with the maximum SUV.
OBJECTIVE: Positron emission tomography with (18)F fludeoxyglucose integrated with CT ((18)F-FDG PET/CT) is a recommended imaging procedure in the evaluation of non-small-cell lung cancers (NSCLCs). Radiochemotherapy (RCT) is a mainstay for treatment of locally advanced NSCLC, for which overall survival still remains poor. Early evaluation of treatment response may help in decision-making to complete radiotherapy (RT) or to switch to other treatment modalities. The present study aimed to evaluate the performance of new metabolic parameters based on a simplified kinetic analysis on a single time point (SKA-S)-derived mathematical method, as compared with standardized uptake value (SUV) measurement during RT. METHODS: Four patients treated with RT or RCT for NSCLC were evaluated using (18)F-FDG PET/CT during RT and after treatment completion. Whole-body (18)F-FDG PET/CT was performed followed by four additional list-mode acquisitions centered over the target lesion. Response was evaluated at four times (i.e. PET1-PET4) by calculating standard SUV values and T80%, the time taken to reach 80% of (18)F-FDG metabolized fraction using a SKA-S-derived mathematical method. RESULTS: Data from SUV and T80% calculations were found to be controversial. T80% was found to be more predictive of clinical outcome. CONCLUSION: Although results from this pilot study should be further confirmed in a large prospective study, the data suggest that T80% is a promising metabolic biomarker for assessing early response to RT. ADVANCES IN KNOWLEDGE: In this proof of concept study, we show that T80% defined from a mathematic model taking into account the net influx rate constant and vascular volume could be consider as a promising biomarker as compared with the maximum SUV.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: Hao Zhang; Kristen Wroblewski; Yulei Jiang; Bill C Penney; Daniel Appelbaum; Cassie A Simon; Ravi Salgia; Yonglin Pu Journal: Lung Cancer Date: 2015-04-09 Impact factor: 5.705
Authors: A Aupérin; C Le Péchoux; J P Pignon; C Koning; B Jeremic; G Clamon; L Einhorn; D Ball; M G Trovo; H J M Groen; J A Bonner; T Le Chevalier; R Arriagada Journal: Ann Oncol Date: 2006-03 Impact factor: 32.976
Authors: Johan Bussink; Johannes H A M Kaanders; Winette T A van der Graaf; Wim J G Oyen Journal: Nat Rev Clin Oncol Date: 2011-01-25 Impact factor: 66.675
Authors: Wouter van Elmpt; Michel Ollers; Anne-Marie C Dingemans; Philippe Lambin; Dirk De Ruysscher Journal: J Nucl Med Date: 2012-08-09 Impact factor: 10.057
Authors: R J Wong; D T Lin; H Schöder; S G Patel; M Gonen; S Wolden; D G Pfister; J P Shah; S M Larson; D H Kraus Journal: J Clin Oncol Date: 2002-10-15 Impact factor: 44.544
Authors: Ronald Boellaard; Mike J O'Doherty; Wolfgang A Weber; Felix M Mottaghy; Markus N Lonsdale; Sigrid G Stroobants; Wim J G Oyen; Joerg Kotzerke; Otto S Hoekstra; Jan Pruim; Paul K Marsden; Klaus Tatsch; Corneline J Hoekstra; Eric P Visser; Bertjan Arends; Fred J Verzijlbergen; Josee M Zijlstra; Emile F I Comans; Adriaan A Lammertsma; Anne M Paans; Antoon T Willemsen; Thomas Beyer; Andreas Bockisch; Cornelia Schaefer-Prokop; Dominique Delbeke; Richard P Baum; Arturo Chiti; Bernd J Krause Journal: Eur J Nucl Med Mol Imaging Date: 2010-01 Impact factor: 9.236
Authors: Feng-Ming Spring Kong; Kirk A Frey; Leslie E Quint; Randall K Ten Haken; James A Hayman; Marc Kessler; Indrin J Chetty; Daniel Normolle; Avraham Eisbruch; Theodore S Lawrence Journal: J Clin Oncol Date: 2007-07-20 Impact factor: 44.544