Evaluation of metabolic response with (18)F-FDG PET-CT in patients with advanced or recurrent thymic epithelial tumors.

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Evaluation of metabolic response with (18)F-FDG PET-CT in patients with advanced or recurrent thymic epithelial tumors.

Cancer Imaging. 2017 Mar 07;17(1):10

Authors: Segreto S, Fonti R, Ottaviano M, Pellegrino S, Pace L, Damiano V, Palmieri G, Del Vecchio S

Abstract
BACKGROUND: 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).
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.

PMID: 28264726 [PubMed - indexed for MEDLINE]

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