Does 18F FDG PET/CT paramaters predict histopathologic response to the neoadjuvant therapy in patients with non-small cell lung cancer?

Article Sidebar

Full Text (PDF)
Published: Oct 30, 2018
Keywords:
18F-FDG CT PET total lesion glycolysis metabolic tumor volume

Main Article Content

Ozlem Yersal
Adnan Menderes University, School of Medicine, Dept. of Medical Oncology, Aydin
Arzu Cengiz
Adnan Menderes University, School of Medicine, Dept. of Nuclear Medicine, Aydin
Salih Cokpinar
Adnan Menderes University, School of Medicine, Dept. of Thoracic Surgery, Aydin
Nesibe Kahraman Cetin
Adnan Menderes University, School of Medicine, Dept. of Pathology, Aydin
Nezih Meydan
Adnan Menderes University, School of Medicine, Dept. of Medical Oncology, Aydin
Sabri Barutca
Adnan Menderes University, School of Medicine, Dept. of Medical Oncology, Aydin
Serdar Sen
Adnan Menderes University, School of Medicine, Dept. of Medical Oncology, Aydin

Abstract

Objective: Progression-free and overall survival are better correlated with metabolically active tumor volume (MTV) and total lesion glycolysis (TLG), as compared to the maximum standardized uptake value (SUVmax) in NSCLC patients. In this study, we aimed to evaluate the correlation between the PET-CT parameters and histopathologic tumor regression score in non-small cell lung cancer(NSCLC) patients after treatment with neoadjuvant chemotherapy.(1)


Methods: This retrospective study evaluated stage III lung cancer patients who were treated with neoadjuvant chemotherapy followed by surgical resection at a single institution between 2014 and 2018. The 3-dimensional volumes of interest were drawn in primary tumor and largest lymph node on the pretreatment examination and corresponding location on the post-treatment examination to obtain a pre- and post-treatment SUVmax, SUVmean, MTV and TLG. All hematoxylin- and eosin-stained surgery specimens were assessed based on a 4-tiered scale.


Results: Patients who had lower than 10% histologic response established higher values of SUVmax, in tumor as compared to good responders in basal PET CT assessment (p:0.014). Patients who established higher than 10% pathologic response showed higher reduction rates in terms of SUVmax (p:0.002), mean tumor volume (p:0.024), and total lesion glycolysis (p:0.009). The overall survival for patients with <10% histologic response was 15.26 months while the patients with good histologic response had 35.36 months and the difference was statistical significance (p<0.001). Due to univariate analysis, the higher SUVmax, TLG and MTV reduction have been found in association with better overall survival.


Conclusion: PET CT parameters may be useful to predict histopathologic response for NSCLC patients who received neoadjuvant chemotherapy

Downloads

Download data is not yet available.

Article Details

How to Cite
Yersal, O. ., Cengiz, A. ., Cokpinar, S. ., Cetin, N. K. ., Meydan, N. ., Barutca, S. ., & Sen, S. . (2018). Does 18F FDG PET/CT paramaters predict histopathologic response to the neoadjuvant therapy in patients with non-small cell lung cancer?. Medical Science and Discovery, 5(10), 344–349. Retrieved from https://medscidiscovery.com/index.php/msd/article/view/259
Issue
Vol. 5 No. 10 (2018): Medical Science and Discovery
Section
Research Article

https://creativecommons.org/licenses/by-nc/4.0/

References

1. Torre LA et al. Global cancer statistics, 2012. Ca Cancer J Clin. 2015;65(2):87-108.
2. Filosso PL, Guerrera F, Lausi PO, Ruffini E. Locally advanced non-small cell lung cancer treatment: another step forward. Journal of Thoracic Disease. 2017;9(12):4908-4911.
3. Nahmias C, Hanna WT, Wahl LM, Long MJ, Hubner KF, Townsend DW. Time course of early response to chemotherapy in non-small cell lung cancer patients with 18F-FDG PET/CT. J Nucl Med. 2007; 48:744–751.
4. Obara P, Pu Y. Prognostic value of metabolic tumor burden in lung cancer. Chinese Journal of Cancer Research. 2013;25(6):615-622.
5. Yu HM, Liu YF, Hou M, et al. Evaluation of gross tumor size using CT, 18F-FDG PET, integrated 18F-FDG PET/CT and pathological analysis in non-small cell lung cancer. Eur J Radiol 2009;72:104-13.
6. Downey RJ, Akhurst T, Gonen M, et al. Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection. J Clin Oncol 2004;22:3255-60.
7. Lee P, Weerasuriya DK, Lavori PW, et al. Metabolic tumor burden predicts for disease progression and death in lung cancer. Int J Radiat Oncol Biol Phys 2007;69:328-33.
8. Zhang H, Wroblewski K, Liao S, et al. Prognostic value of metabolic tumor burden from 18F-FDG PET in surgical patients with non-small-cell lung cancer. Acad Radiol 2013;20:32-40.
9. Chen HH, Chiu NT, Su WC, Guo HR, Lee BF. Prognostic value of whole-body total lesion glycolysis at pretreatment FDG PET/CT in non-small cell lung cancer. Radiology. 2012;264(2):559-66.
10. Junker K, Langner K, Klinke F, Bosse U, Thomas M. Grading of tumor regression in non-small cell lung cancer : morphology and prognosis. Chest. 2001;120(5):1584-91.
11. Sugawara Y, Zasadny KR, Neuhoff AW, et al. Reevaluation of the standardized uptake value for FDG: variations with body weight and methods for correction. Radiology 1999;213:521-5.
12. Hamberg LM, Hunter GJ, Alpert NM, et al. The dose uptake ratio as an index of glucose metabolism:useful parameter or oversimplification? J Nucl Med 1994;35:1308-12.
13. Weber WA, Schwaiger M, Avril N. Quantitative assessment of tumor metabolism using FDG-PET imaging. Nucl Med Biol 2000;27:683-7.
14. Cerfolio RJ1, Bryant AS, Winokur TS, Ohja B, Bartolucci AA. Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non-small cell lung cancer. Ann Thorac Surg. 2004 Dec;78(6):1903-9
15. Lee P, Weerasuriya DK, Lavori PW, et al. Metabolic tumor burden predicts for disease progression and death in lung cancer. Int J Radiat Oncol Biol Phys 2007;69:328-33.
16. Kim K, Kim SJ, Kim IJ, et al. Prognostic value of volumetric parameters measured by F-18 FDG PET/CT in surgically resected non-small-cell lung cancer. Nucl Med Commun 2012;33:613-20.
17. Hyun SH, Ahn HK, Kim H, et al. Volume-based assessment by 18F-FDG PET/CT predicts survival in patients with stage III non-small-cell lung cancer. Eur J Nucl Med Mol Imaging 2014;41:50-8.