PERCIST in Perspective

O, Joo Hyun; Wahl, Richard L.

doi:10.1007/s13139-017-0507-4

Cited by 29 publications

(12 citation statements)

References 20 publications

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“…It is simple and quick to measure but is subject to noise because its value is taken from a single voxel. Alternatively, SUV mean, median or standard deviation within a VOI bounded by a threshold SUV may be more robust [17]. SUV thresholds for bounding VOI may be absolute (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Volumetric PET parameters include the MTV, a measure of metabolic tumour volume above a threshold SUV, and total lesion glycolysis (TLG), which is the product of the mean SUV and MTV. Many feel that MTV and TLG better reflect metabolic tumour burden [17] and studies that have correlated MTV and TLG with prognosis [18–20] have included both cervical and head and neck cancer treated with CRT [21, 22].…”

Section: Discussionmentioning

confidence: 99%

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FDG-PET parameters predict for recurrence in anal cancer – results from a prospective, multicentre clinical trial

et al. 2019

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Background To investigate the prognostic significance of positron emission tomography (PET) parameters from F-18 fluorodeoxyglucose (FDG) PET scans performed pre- and post- chemo-radiotherapy (CRT) for squamous cell carcinoma of the anal canal (AC). Methods From January 2013 to January 2017, 19 patients with non-metastatic AC enrolled on a prospective trial underwent FDG-PET/CT imaging before and 12 weeks following CRT. A computer-generated volume of interest (VOI) was snapped around the primary tumour using six different standard uptake value (SUV) thresholds and the following parameters were extracted: SUV max, mean, median, standard deviation and peak as well as metabolic tumour volume (MTV) and total lesion glycolysis. Exact logistic regression and ROC AUC analyses were performed for each metric at each timepoint. Results With a median follow up of 15.8 months, 3/19 patients had a local recurrence and 5/19 had any recurrence. On post-CRT PET, the median SUV within a VOI bounded by an SUV of 3 correlated with local recurrence ( p < 0.01) and demonstrated excellent discrimination (ROC AUC 1.00, perfect separation was achieved at a median SUV of 3.38). The mean SUV at this threshold did not quite reach significance for prediction of local recurrence ( p = 0.06) but demonstrated excellent discrimination (ROC AUC 0.91). The MTV bounded by a threshold of 41% SUVmax on the pre-CRT PET predicted for any recurrence ( p = 0.03) and showed excellent discrimination (ROC AUC 0.89). Conclusions FDG-PET parameters are predictive of recurrence in AC. FDG-PET may represent a valuable tool for prognostication and response assessment in AC. Trial registration ANZCTR, ACTRN12614001219673 . Registered 19 November 2014 - Retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

FDG-PET parameters predict for recurrence in anal cancer – results from a prospective, multicentre clinical trial

et al. 2019

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“…For example, a recent study suggested that FDG-PET/CT performed 14 days after the start of neo-adjuvant chemotherapy in patients with locally advanced disease was able to identify patients with poor outcomes, based on an increase in regional lymph node maximum SUV and insufficient decrease in primary tumor uptake after 2 weeks of treatment (47). Currently, the PERCIST thresholds (decrease ≥30%) do not vary according to the number of treatment cycles received (i.e., mid-treatment or end-oftreatment), which may change in subsequent versions (48). Specifically for head-and-neck cancer response assessment, Marcus et al proposed the Hopkins 5-point interpretation criteria to assess locoregional response after chemoradiotherapy.…”

Section: Standardized Reportingmentioning

confidence: 99%

Quality Assessment in FDG-PET/CT Imaging of Head-and-Neck Cancer: One Home Run Is Better Than Two Doubles

2020

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2-deoxy-2-[ 18 F]fluoro-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is indicated in head-and-neck cancer for the initial workup when clinically indicated (e. g., large tumors, clinically positive neck, cervical adenopathy from an unknown primary, etc.), for the assessment of treatment response 12 weeks after completion of (chemo)radiotherapy, and during follow-up when there is suspicion of relapse. The successful implementation of FDG-PET/CT in routine clinical practice requires an in-depth understanding of the recent advances in physics and engineering that have significantly improved the imaging capabilities of PET/CT scanners (e.g., digital silicon photomultipliers, point-spread function modeling, and time-of-flight, and Bayesian penalized likelihood reconstruction). Moreover, a coordinated harmonization effort from professional societies (e.g., EANM) and international bodies (e.g., IAEA) has resulted in the creation of quality assurance frameworks (e.g., QUANUM, EARL, GMP) and guidelines that collectively cover the entire spectrum from tracer production, hardware calibration, patient preparation, and scan acquisition, to image interpretation (e.g., PERCIST, Hopkins criteria). The ultimate goal is to standardize the PET/CT technique and to guarantee accurate and reproducible imaging results for every patient. This review summarizes the recent technical breakthroughs in PET/CT scan design and describes the existing quality assessment frameworks with a focus on applications in head-and-neck cancer. Strict adherence to these harmonization efforts will enable leveraging the full potential of PET/CT and translate the proven benefits of this technique into tangible improvements in outcome for patients with head-and-neck cancer in routine clinical care.

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“…A further issue is the standardization of acquisition and quantification procedures. This has been addressed by several authors in papers about PERCIST [5,6,29,30]. Scanners and reconstructions methods are under continuous technical improvement [29] to improve not only the quality of imaging but also the quantitative measures.…”

Section: Tomorrowmentioning

confidence: 99%

FDG-PET/CT for Response Monitoring in Metastatic Breast Cancer: Today, Tomorrow, and Beyond

Lauridsen

Vogsen

Holm

et al. 2019

Cancers

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While current international guidelines include imaging of the target lesion for response monitoring in metastatic breast cancer, they do not provide specific recommendations for choice of imaging modality or response criteria. This is important as clinical decisions may vary depending on which imaging modality is used for monitoring metastatic breast cancer. FDG-PET/CT has shown high accuracy in diagnosing metastatic breast cancer, and the Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) have shown higher predictive values than the CT-based Response Evaluation Criteria in Solid Tumors (RECIST) for prediction of progression-free survival. No studies have yet addressed the clinical impact of using different imaging modalities or response evaluation criteria for longitudinal response monitoring in metastatic breast cancer. We present a case study of a patient with metastatic breast cancer who was monitored first with conventional CT and then with FDG-PET/CT. We retrospectively applied PERCIST to evaluate the longitudinal response to treatment. We used the one-lesion PERCIST model measuring SULpeak in the hottest metastatic lesion on consecutive scans. This model provides a continuous variable that allows graphical illustration of disease fluctuation along with response categories. The one-lesion PERCIST approach seems able to reflect molecular changes and has the potential to support clinical decision-making. Prospective clinical studies addressing the clinical impact of PERCIST in metastatic breast cancer are needed to establish evidence-based recommendations for response monitoring in this disease.

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PERCIST in Perspective

Cited by 29 publications

References 20 publications

FDG-PET parameters predict for recurrence in anal cancer – results from a prospective, multicentre clinical trial

FDG-PET parameters predict for recurrence in anal cancer – results from a prospective, multicentre clinical trial

Quality Assessment in FDG-PET/CT Imaging of Head-and-Neck Cancer: One Home Run Is Better Than Two Doubles

FDG-PET/CT for Response Monitoring in Metastatic Breast Cancer: Today, Tomorrow, and Beyond

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