Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non-small cell lung cancer
Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non-small cell lung cancer
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DOI：
10.1016/j.athoracsur.2004.06.102
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发表时间：
2004-12-01
影响因子：
4.6
通讯作者：
Bartolucci, AA
中科院分区：
文献类型：
--
作者：
Cerfolio, RJ;Bryant, AS;Bartolucci, AA
背景。采用18f -氟氧葡萄糖（FDG）重复正电子发射断层扫描（PET）和胸部计算机断层扫描（CT）评估非小细胞肺癌（NSCLC）患者放化疗的有效性；然而，标准化摄取值（SUV）的变化与原发肿瘤的病理改变没有相关性。这是一项回顾性队列研究，对56例患者的前瞻性数据库进行了回顾性队列研究，这些患者在新辅助治疗前后进行了非小细胞肺癌、FDG-PET和胸部CT扫描，然后完全切除了癌症。测量最大suv （maxSUV）和肿瘤大小，并将变化百分比与肿瘤细胞无活力百分比进行比较。主要目的是测量这些值之间的相关程度。maxSUV的变化与切除肿瘤中不能存活的肿瘤细胞百分比呈近似线性关系。FDG-PET的maxSUV与病理的相关性优于CT扫描的大小变化(r（2) = 0.75, r(2) = 0.03, p < 0.001）。当maxSUV下降80%或更多时，可以预测完整的病理反应，敏感性为90%，特异性为100%，准确性为96%。新辅助治疗后FDG-PET扫描上maxSUV的变化与病理反应呈近似线性关系。它比CT扫描的大小变化更准确。当maxSUV降低80%或更多时，无论细胞类型、新辅助治疗或最终绝对rnaxSUV如何，患者都可能是完全有效的。这些发现可能有助于指导治疗策略。(C) 2004年由胸外科学会出版。
Background. Repeat positron emission tomography (PET) with 18F-fluorocleoxyglucose (FDG) and chest computed tomography (CT) are used to assess the effectiveness of chemoradiotherapy in patients with non-small cell lung cancer (NSCLC); however, the change in the standardized uptake values (SUV) has not been correlated with the pathologic change of the primary tumor.Methods. This is a retrospective cohort study of a prospective database of 56 patients who had NSCLC, FDG-PET, and chest CT scans both before and after neoadjuvant therapy, followed by complete resection of their cancer. Maximum SUVs (maxSUV) and tumor size were measured, and the percentage of change was compared with the percentage of nonviable tumor cells. The primary objective was to measure the degree of correlation between these values.Results. The change in the maxSUV has a near linear relationship to the percent of nonviable tumor cells in the resected tumors. FDG-PET's maxSUV is better correlated to pathology than the change in size on CT scan (r(2) = 0.75, r(2) = 0.03, p < 0.001). When the maxSUV decreased by 80% or more, a complete pathologic response could be predicted with a sensitivity of 90%, specificity of 100%, and accuracy of 96%.Conclusions. The change in maxSUV on FDG-PET scan after neoadjuvant therapy holds a near linear relationship with pathologic response. It is a more accurate predictor than the change of size on CT scan. When the maxSUV decreases by 80% or more it is likely that the patient is a complete responder irrespective of cell type, neoadjuvant treatment, or the final absolute rnaxSUV. These findings may help guide treatment strategies. (C) 2004 by The Society of Thoracic Surgeons.