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J Nucl Med. 2010 Dec;51(12):1833-40. doi: 10.2967/jnumed.110.076778. Epub 2010 Nov 15.

18F-FDG PET/CT for the prediction and detection of local recurrence after radiofrequency ablation of malignant lung lesions.

Author information

1
Department of Radiology/Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. amitsingnurkar@gmail.com

Erratum in

  • J Nucl Med. 2011 Jan;52(1):106.

Abstract

The utility of (18)F-FDG PET/CT for response assessment in malignant lung tumors treated with radiofrequency ablation (RFA) and for the detection and prediction of local recurrence was investigated.

METHODS:

Between December 17, 2003, and April 9, 2008, 68 consecutive patients (mean age, 68 y) with 94 pulmonary lesions, including metastases (n = 38) and primary lung cancers (n = 44), underwent RFA. Because of inadequate imaging follow-up in 12 patients, only 82 lesions were analyzed (CT scans, n = 82; (18)F-FDG PET/CT scans, n = 62). The median follow-up was 25 mo (range, 12-66 mo). A baseline study was defined as (18)F-FDG PET/CT performed no more than 3 mo before RFA. The first postablation scan was defined as PET/CT performed between 1 and 4 mo after RFA; additional follow-up studies were obtained in some cases between 6 and 12 mo after RFA. The unidimensional maximum diameter of the lesion was recorded on a pretherapy diagnostic CT scan or on the CT component of a pretherapy (18)F-FDG PET/CT scan, whichever was obtained most recently, using lung windows. Maximum standardized uptake values (SUVs) were recorded for all lesions imaged by (18)F-FDG PET/CT. (18)F-FDG uptake patterns on post-RFA scans were classified as favorable or unfavorable. Survival and recurrence probabilities were estimated using the Kaplan-Meier method. Uni- and multivariate analyses were also performed.

RESULTS:

Before RFA, factors predicting greater local recurrence-free survival included initial lesion size less than 3 cm (P = 0.01) and SUV less than 8 (P = 0.02), although the latter was not an independent predictor in multivariate analysis. Treated metastases recurred less often than treated primary lung cancers (P = 0.03). Important post-RFA factors that related to reduced recurrence-free survival included an unfavorable uptake pattern (P < 0.01), post-RFA SUV (P < 0.01), and an increase in SUV over time after ablation (P = 0.05).

CONCLUSION:

(18)F-FDG PET/CT parameters on both preablation and postablation scans may predict local recurrence in patients treated with RFA for lung metastases and primary lung cancers.

PMID:
21078787
DOI:
10.2967/jnumed.110.076778
[Indexed for MEDLINE]
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