Stage Migration in Planning PET/CT Scans in Patients Due to Receive Radiotherapy for Non–Small-Cell Lung Cancer
| Autor: | John P. Plastaras, Surbhi Grover, Geoffrey A. Geiger, Daniel A. Pryma, Ramesh Rengan, Charles B. Simone, Eric Xanthopoulos, Miranda B. Kim, Corey J. Langer |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Standardized uptake value Adenocarcinoma Fluorodeoxyglucose F18 Carcinoma Non-Small-Cell Lung medicine Humans Stage (cooking) Lung cancer Radiation treatment planning Aged Neoplasm Staging Retrospective Studies Aged 80 and over PET-CT business.industry Radiotherapy Planning Computer-Assisted Middle Aged Prognosis medicine.disease Radiation therapy Oncology Tumor progression Positron-Emission Tomography Carcinoma Squamous Cell Carcinoma Large Cell Female Radiology Radiopharmaceuticals Tomography X-Ray Computed business Nuclear medicine Chemoradiotherapy Follow-Up Studies |
| Zdroj: | Clinical Lung Cancer. 15:79-85 |
| ISSN: | 1525-7304 |
| Popis: | Introduction This study examined rates of tumor progression in treatment-naive patients with non–small-cell lung cancer (NSCLC) as determined by repeat treatment-planning fluorine-18 ( 18 F) fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT). Methods and Materials This study assessed patients who underwent PET/CT simulation for NSCLC stage II/III, radiation-naive, nonmetastatic NSCLC. It compared planning PET/CT with previous PET/CT images. Patients were analyzed for change in stage, treatment intent, or both. Progression was defined as a change in TNM status leading to upstaging, and standardized uptake value (SUV) velocity was defined as [(SUV scan2 − SUV scan1 )/interscan interval in days]. Results Of 149 consecutive patients examined between April 2009 and April 2011, 47 had prior PET/CT scans and were included. The median age was 68 years. New nodal disease or metastatic disease was identified in 24 (51%) of 47 patients. Fourteen (30%) had evidence of extrathoracic metastatic disease; the remaining 10 (21%) had new nodal disease that required substantial alteration of treatment fields. At a scan interval of 20 days, the rate of upstaging was 17%. SUV velocity was analyzed in the subset of patients who had their studies on the identical PET/CT scanner (n = 14). Nonupstaged patients had a mean SUV velocity of 0.074 units per day, compared with 0.11 units per day in patients that were upstaged by their second PET/CT scan ( P = .020). Conclusion Radiation treatment planning with hybrid PET/CT scans repeated within 120 days of an initial staging PET/CT scan identified significant upstaging in more than half of patients. For a subset of patients who underwent both scans on the same instrument, SUV velocity predicts upstaging, and the difference between those upstaged and those not was statistically significant. |
| Databáze: | OpenAIRE |
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