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Br J Radiol. 2016 Jun;89(1062):20160061. doi: 10.1259/bjr.20160061. Epub 2016 Apr 4.

An alternative parameter for early forecasting clinical response in NSCLC patients during radiotherapy: proof of concept study.

Author information

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.

PMID:
27043244
PMCID:
PMC5258176
DOI:
10.1259/bjr.20160061
[Indexed for MEDLINE]
Free PMC Article

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