Time trends in the maximal uptake of FDG on PET scan during thoracic radiotherapy. A prospective study in locally advanced non-small cell lung cancer (NSCLC) patients

Baardwijk, Angela van; Bosmans, Geert; Dekker, André; Kroonenburgh, Marinus van; Boersma, Liesbeth; Wanders, S; Öllers, Michel; Houben, Ruud; Minken, A.; Lambin, Philippe; Ruysscher, Dirk De

doi:10.1016/j.radonc.2007.01.007

Cited by 102 publications

(83 citation statements)

References 52 publications

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“…In addition, other areas that warrant attention include the assessment of the FDG signal during treatment to see if they correlate with treatment outcomes [39]. Finally, different forms of biological imaging agents or protocols that examine perfusion and hypoxia [33,40], may also warrant further study.…”

Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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“…Functional imaging using 18 F-FDG PET has gained widespread acceptance for diagnosis and staging in oncology and has proven prognostic value for NSCLC (12). The application of 18 F-FDG PET for the prediction of therapy response and treatment outcome has been shown in advanced stage NSCLC during induction chemotherapy (13)(14)(15)(16), during radiotherapy (17), and after neoadjuvant chemotherapy (18). Data for response prediction of 18 F-FDG PET in locally advanced NSCLC treated with concomitant therapy are limited.…”

mentioning

confidence: 99%

¹⁸F-FDG PET Early Response Evaluation of Locally Advanced Non–Small Cell Lung Cancer Treated with Concomitant Chemoradiotherapy

et al. 2013

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The potential of 18 F-FDG PET changes was evaluated for prediction of response to concomitant chemoradiotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods: For 28 patients, 18 F-FDG PET was performed before treatment, at the end of the second week of treatment, and at 2 wk and 3 mo after the completion of treatment. Standardized uptake value (SUV), maximum SUV, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained. Early metabolic changes were defined as fractional change (DTLG) when 18 F-FDG PET at the end of the second week was compared with pretreatment 18 F-FDG PET. In-treatment metabolic changes, as measured by serial 18 F-FDG PET, were correlated with standard criteria of response evaluation of solid tumors by means of CT imaging (Response Evaluation Criteria In Solid Tumors 1.1). Parameters were analyzed for stratification in progression-free survival (PFS). Results: When compared with early metabolic nonresponders, a DTLG decrease of 38% or more was associated with a significantly longer PFS (1-y PFS 80% vs. 36%, P 5 0.02). Pretreatment TLG was found to be a prognostic factor for PFS. Conclusion: The degree of change in TLG was predictive for response to concomitant chemoradiotherapy as early as the end of the second week into treatment for patients with locally advanced NSCLC. Pretreatment TLG was prognostic for PFS.

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“…Furthermore, various small clinical studies have demonstrated that 18 F-FDG PET/CT imaging during the course of radiotherapy can predict late metabolic response or clinical outcome in NSCLC patients (82,83). Timing in sequential 18 F-FDG PET imaging for early response assessment is extremely important, as has been clearly demonstrated by van Baardwijk et al, who have shown that 18 F-FDG PET SUV max in nonresponding NSCLC patients increased in the first week of radiotherapy and then decreased in the second week of radiotherapy and after radiotherapy (84). In contrast, changes in SUV max for responding patients were negligible during radiotherapy and notably negative after radiotherapy.…”

Section: Prognostic Role Of Molecular Imaging In Radiation Therapymentioning

confidence: 97%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

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Time trends in the maximal uptake of FDG on PET scan during thoracic radiotherapy. A prospective study in locally advanced non-small cell lung cancer (NSCLC) patients

Cited by 102 publications

References 52 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

¹⁸F-FDG PET Early Response Evaluation of Locally Advanced Non–Small Cell Lung Cancer Treated with Concomitant Chemoradiotherapy

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

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Time trends in the maximal uptake of FDG on PET scan during thoracic radiotherapy. A prospective study in locally advanced non-small cell lung cancer (NSCLC) patients

Cited by 102 publications

References 52 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

18F-FDG PET Early Response Evaluation of Locally Advanced Non–Small Cell Lung Cancer Treated with Concomitant Chemoradiotherapy

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

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Product

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¹⁸F-FDG PET Early Response Evaluation of Locally Advanced Non–Small Cell Lung Cancer Treated with Concomitant Chemoradiotherapy