scholarly journals PET/CT imaging for evaluation of multimodal treatment efficacy and toxicity in advanced NSCLC—current state and future directions

2021 ◽  
Author(s):  
Chukwuka Eze ◽  
Nina-Sophie Schmidt-Hegemann ◽  
Lino Morris Sawicki ◽  
Julian Kirchner ◽  
Olarn Roengvoraphoj ◽  
...  
Keyword(s):  
Treatment Efficacy ◽  
Fdg Pet ◽  
Hybrid Imaging ◽  
Advanced Nsclc ◽  
Response Assessment ◽  
Response Criteria ◽  
Future Directions ◽  
Current State ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC, leading to a string of approvals in recent years. Herein, a narrative review on the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the ever-evolving treatment landscape of advanced NSCLC is presented. Methods This comprehensive review will begin with an introduction into current treatment paradigms incorporating ICIs; the evolution of CT-based criteria; moving onto novel phenomena observed with ICIs and the current state of hybrid imaging for diagnosis, treatment planning, evaluation of treatment efficacy and toxicity in advanced NSCLC, also taking into consideration its limitations and future directions. Conclusions The advent of ICIs marks the dawn of a new era bringing forth new challenges particularly vis-à-vis treatment response assessment and observation of novel phenomena accompanied by novel systemic side effects. While FDG PET/CT is widely adopted for tumor volume delineation in locally advanced disease, response assessment to immunotherapy based on current criteria is of high clinical value but has its inherent limitations. In recent years, modifications of established (PET)/CT criteria have been proposed to provide more refined approaches towards response evaluation. Not only a comprehensive inclusion of PET-based response criteria in prospective randomized controlled trials, but also a general harmonization within the variety of PET-based response criteria is pertinent to strengthen clinical implementation and widespread use of hybrid imaging for response assessment in NSCLC.

scholarly journals Usefulness of 18f-FDG PET-CT in Staging, Restaging, and Response Assessment in Pediatric Rhabdomyosarcoma

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1112
Author(s):  
Davide Donner ◽  
Paola Feraco ◽  
Linda Meneghello ◽  
Barbara Rombi ◽  
Lorena Picori ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Pediatric Patients ◽  
Response Assessment ◽  
Response To Therapy ◽  
High Morbidity ◽  
European Guidelines ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Clinical Advances

Rhabdomyosarcoma is the most common soft-tissue sarcoma of childhood. Despite clinical advances, subsets of these patients continue to suffer high morbidity and mortality rates associated with their disease. Following the European guidelines for 18F-FDG PET and PET-CT imaging in pediatric oncology, the routine use of 18F-FDG PET-CT may be useful for patients affected by rhabdomyosarcoma, in staging, in the evaluation of response to therapy, and for restaging/detection of relapse. The European Pediatric Protocols are very old, and for staging and restaging, they recommend only radionuclide bone scan. The 18F-FDG PET-CT exam is listed as an optional investigation prescribed according to local availability and local protocols in the investigations panel required at the end of the treatment. We present two cases highlighting the usefulness of 18F-FDG PET-CT in managing pediatric patients affected by rhabdomyosarcoma, providing some bibliographic references.

PH-0040: A 6-point scale approach to 18F-FDG PET-CT for response assessment in HNSCC: a multicenter study

2020 ◽  
Vol 152 ◽  
pp. S11-S12
Author(s):  
P. Bonomo ◽  
A. Merlotti ◽  
S. Morbelli ◽  
V. Berti ◽  
C. Saieva ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Fdg Pet ◽  
Response Assessment ◽  
Point Scale ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

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

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1163 ◽  
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.

Response assessment in relapsing polychondritis with 18F-FDG PET/CT

2017 ◽  
Vol 36 (2) ◽  
pp. 124-125
Author(s):  
T.K. Jain ◽  
A. Sood ◽  
A. Sharma ◽  
R.K. Basher ◽  
A. Bhattacharya ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Relapsing Polychondritis ◽  
Response Assessment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct
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