Title |
Evaluation of metabolic response with 18F-FDG PET-CT in patients with advanced or recurrent thymic epithelial tumors
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Published in |
Cancer Imaging, March 2017
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DOI | 10.1186/s40644-017-0112-x |
Pubmed ID | |
Authors |
Sabrina Segreto, Rosa Fonti, Margaret Ottaviano, Sara Pellegrino, Leonardo Pace, Vincenzo Damiano, Giovannella Palmieri, Silvana Del Vecchio |
Abstract |
Patients with advanced or recurrent thymic epithelial tumors (TETs) often need several consecutive lines of chemotherapy. The aim of this retrospective monocentric study was to test whether (18)F-Fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) is able to monitor standard chemotherapy efficacy in those patients and whether metabolic response correlates with morphovolumetric response as assessed by Response Evaluation Criteria in Solid Tumor (RECIST). We evaluated 27 consecutive patients with advanced (16 patients) or recurrent (11 patients) TETs. All patients underwent (18)F-FDG PET-CT before and after at least 3 cycles of chemotherapy. Maximum standardized uptake value (SUVmax) of all detected lesions was recorded and the most (18)F-FDG avid lesion in each patient was selected for determination of percentage change of SUVmax (ΔSUVmax) in pre- and post-treatment scans. Tumor response was assessed by contrast-enhanced computed tomography (CE-CT) using RECIST criteria. Receiver operating characteristic (ROC) curve analysis was performed to define the optimal threshold of ΔSUVmax discriminating responders from non-responders. Metabolic response expressed as ΔSUVmax was significantly correlated with morphovolumetric response (Spearman's rank correlation, r = 0.64, p = 0.001). ROC curve analysis showed that a ΔSUVmax value of -25% could discriminate responders from non-responders with a sensitivity of 88% and a specificity of 80%. Conversely, basal SUVmax values were not predictive of morphovolumetric tumor response. Our findings indicate that metabolic response assessed by (18)F-FDG PET-CT, through evaluation of ΔSUVmax, may allow identification of responders and non-responders thus guiding adaptation of therapy in patients with advanced or recurrent TETs. |
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