STEREOTACTIC HYPO-FRACTIONAL RADIOTHERAPY OF PATIENTS WITH LUNG CANCER I-IIA CLINICAL STAGE: THE ROLE OF SUVMAX ASSESSMENT IN 18F-FDG PET/CT FOR MONITORING TREATMENT OUTCOMES

2017 ◽  
Vol 63 (4) ◽  
pp. 632-638
Author(s):  
Tatyana Borisova ◽  
Arif Allakhverdiev ◽  
Yuriy Gerasimov ◽  
Nadezhda Meshcheryakova ◽  
Mikhail Dolgushin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Treatment Effectiveness ◽  
Clinical Stage ◽  
First Year ◽  
Pet Ct ◽  
History Of ◽  
Single Factor Analysis ◽  
Fdg Pet Ct ◽  
Second Tumor ◽  
Monitoring Treatment

Material and methods: Since 2014, 33 patients with lung cancer of clinical stage I-IIa (cT1N0M0 - 12 patients, with T2N0M0 - 21 patients) have undergone SRT. Verification of tumor process was obtained in 30 patients. A third of patients (n = 10) had a history of metachronic primary-multiple tumors and 31 patients had peripheral lung cancer. The used variants of SRT fractionation were as followed: 10Gr x 5 fractions (n = 22) and 7Gr x 8 fractions (n = 11) - BED 100Gy. Results: With a median follow-up of 21 months (range 3-37 months), 4 patients (12 %) within the first year had a loco-regional and distant progression, of which two died. During the year one patient died from complications of treatment, one - from the progression of the second tumor. One- and two-year local control was 94 %. Overall and disease-free 2-year survival was 84 % (95 % CI, 70 - 99) and 83.2 % (95 % CI, 70.5 - 99), respectively. Single-factor analysis revealed a significant effect on the overall survival of the fractionation regimen (p = 0.04). The effect of the baseline SUVmax tended to be reliable (p = 0.07). Conclusions: In order to implement the principles of risk-adaptive radiation therapy it is necessary to consider the initial SUVmax of tumor as one of potential predictive and predicative markers of treatment effectiveness.

scholarly journals Potential Pitfall in the Assessment of Lung Cancer with FDG-PET/CT: Talc Pleurodesis Causes Intrathoracic Nodal FDG Avidity

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Yingbing Wang ◽  
Brett W. Carter ◽  
Victorine Muse ◽  
Subba Digumarthy ◽  
Jo-Anne Shepard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Fdg Pet ◽  
Common Finding ◽  
Talc Pleurodesis ◽  
High Attenuation ◽  
Pet Ct ◽  
Pattern Size ◽  
History Of ◽  
Fdg Pet Ct

Objective. Talc pleurodesis is a common procedure performed to treat complications related to lung cancer. The purpose of our study was to characterize any thoracic nodal findings on FDG PET/CT associated with prior talc pleurodesis. Materials and Methods. The electronic medical record identified 44 patients who underwent PET/CT between January 2006 and December 2010 and had a history of talc pleurodesis. For each exam, we evaluated the distribution pattern, size, and attenuation of intrathoracic lymph nodes and the associated standardized uptake value. Results. High-attenuation intrathoracic lymph nodes were noted in 11 patients (25%), and all had corresponding increased FDG uptake (range 2–9 mm). Involved nodal groups were anterior peridiaphragmatic (100%), paracardiac (45%), internal mammary (25%), and peri-IVC (18%) nodal stations. Seven of the 11 patients (63%) had involvement of multiple lymph nodal groups. Mean longitudinal PET/CT and standalone CT followups of 15±11 months showed persistence of both high-attenuation and increased uptake at these sites, without increase in nodal size suggesting metastatic disease involvement. Conclusions. FDG avid, high-attenuation lymph nodes along the lymphatic drainage pathway for parietal pleura are a relatively common finding following talc pleurodesis and should not be mistaken for nodal metastases during the evaluation of patients with history of lung cancer.

Enhancing 18F-FDG-PET/CT analysis in lung cancer patients

2015 ◽  
Vol 54 (06) ◽  
pp. 247-254 ◽  
Author(s):  
A. Kapfhammer ◽  
T. Winkens ◽  
T. Lesser ◽  
A. Reissig ◽  
M. Steinert ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Image Fusion ◽  
Chest Wall ◽  
Fdg Pet ◽  
Ct Image ◽  
Lung Cancers ◽  
Pet Ct ◽  
Peripheral Lung ◽  
Fdg Pet Ct ◽  
Tumour Infiltration

SummaryAim: To retrospectively evaluate the feasibility and value of CT-CT image fusion to assess the shift of peripheral lung cancers with/-out chest wall infiltration, comparing computed tomography acquisitions in shallow-breathing (SB-CT) and deep-inspiration breath-hold (DIBH-CT) in patients undergoing FDG-PET/ CT for lung cancer staging. Methods: Image fusion of SB-CT and DIBH-CT was performed with a multimodal workstation used for nuclear medicine fusion imaging. The distance of intrathoracic landmarks and the positional shift of tumours were measured using semitransparent overlay of both CT series. Statistical analyses were adjusted for confounders of tumour infiltration. Cutoff levels were calculated for prediction of no-/infiltration. Results: Lateral pleural recessus and diaphragm showed the largest respiratory excursions. Infiltrating lung cancers showed more limited respiratory shifts than non-infiltrating tumours. A large respiratory tumour-motility accurately predicted non-infiltration. However, the tumour shifts were limited and variable, limiting the accuracy of prediction. Conclusion: This pilot fusion study proved feasible and allowed a simple analysis of the respiratory shifts of peripheral lung tumours using CT-CT image fusion in a PET/CT setting. The calculated cutoffs were useful in predicting the exclusion of chest wall infiltration but did not accurately predict tumour infiltration. This method can provide additional qualitative information in patients with lung cancers with contact to the chest wall but unclear CT evidence of infiltration undergoing PET/CT without the need of additional investigations. Considering the small sample size investigated, further studies are necessary to verify the obtained results.

scholarly journals Impact of [18F]FDG-PET and [18F]FLT-PET-Parameters in Patients with Suspected Relapse of Irradiated Lung Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 279
Author(s):  
Tine N. Christensen ◽  
Seppo W. Langer ◽  
Gitte Persson ◽  
Klaus Richter Larsen ◽  
Annemarie G. Amtoft ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Fdg Pet ◽  
Tumor Volume ◽  
High Dose ◽  
Flt Pet ◽  
Pet Ct ◽  
Radiation Induced ◽  
Fdg Pet Ct ◽  
Induced Changes

Radiation-induced changes may cause a non-malignant high 2-deoxy-2-[18F]fluoro-d-glucose (FDG)-uptake. The 3′-deoxy-3′-[18F]fluorothymidine (FLT)-PET/CT performs better in the differential diagnosis of inflammatory changes and lung lesions with a higher specificity than FDG-PET/CT. We investigated the association between post-radiotherapy FDG-PET-parameters, FLT-PET-parameters, and outcome. Sixty-one patients suspected for having a relapse after definitive radiotherapy for lung cancer were included. All the patients had FDG-PET/CT and FLT-PET/CT. FDG-PET- and FLT-PET-parameters were collected from within the irradiated high-dose volume (HDV) and from recurrent pulmonary lesions. For associations between PET-parameters and relapse status, respectively, the overall survival was analyzed. Thirty patients had a relapse, of these, 16 patients had a relapse within the HDV. FDG-SUVmax and FLT-SUVmax were higher in relapsed HDVs compared with non-relapsed HDVs (median FDG-SUVmax: 12.8 vs. 4.2; p < 0.001; median FLT-SUVmax 3.9 vs. 2.2; p < 0.001). A relapse within HDV had higher FDG-SUVpeak (median FDG-SUVpeak: 7.1 vs. 3.5; p = 0.014) and was larger (median metabolic tumor volume (MTV50%): 2.5 vs. 0.7; 0.014) than the relapsed lesions outside of HDV. The proliferative tumor volume (PTV50%) was prognostic for the overall survival (hazard ratio: 1.07 pr cm3 [1.01–1.13]; p = 0.014) in the univariate analysis, but not in the multivariate analysis. FDG-SUVmax and FLT-SUVmax may be helpful tools for differentiating the relapse from radiation-induced changes, however, they should not be used definitively for relapse detection.

Impact of preoperative 18F-FDG PET/CT on survival of resected mono-metastatic non-small cell lung cancer

Lung Cancer ◽  
2016 ◽  
Vol 93 ◽  
pp. 28-34 ◽  
Author(s):  
Simone Tönnies ◽  
Mario Tönnies ◽  
Jens Kollmeier ◽  
Torsten T. Bauer ◽  
Gregor J. Förster ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Fdg Pet ◽  
Small Cell ◽  
Small Cell Lung ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct
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