Positron Emission Tomography Using [<sup>18</sup>F]Fluorodeoxyglucose for Monitoring Primary Chemotherapy in Breast Cancer

Schelling, M.; Avril, Norbert; Nährig, Jörg; Kuhn, Walther; Römer, Wolfgang; Sattler, Daniel; Werner, Martin; Dose, J.; Jänicke, F.; Graeff, H.; Schwaiger, Markus

doi:10.1200/jco.2000.18.8.1689

Cited by 482 publications

(240 citation statements)

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“…Two recently published reports suggest that F-18 FDG-PET may be valuable for the prediction of response to neoadjuvant chemotherapy in patients with advanced breast cancer. Schelling et al (2000) demonstrated that in breast cancer patients F-18 FDG-PET can differentiate responders from non-responders already after the first cycle of neoadjuvant chemotherapy with a high rate of accuracy. Similar results were reported by Smith et al (2000).…”

Section: Discussionmentioning

confidence: 99%

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

et al. 2002

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To assess the ability of [ 18 F]fluorodeoxyglucose positron emission tomography for the early prediction of response in patients with relapsed metastatic germ cell tumours undergoing salvage high-dose chemotherapy. The role of positron emission tomography was compared with established means of tumour response assessment such as CT scans/MRI and serum tumour marker changes. In addition, positron emission tomography was compared with a current prognostic score which differentiates three prognostic groups with failure-free survival rates ranging from 5 -50%. [ 18 F]fluorodeoxyglucose uptake of metastases from germ cell tumours as well as CT scans and serum tumour marker were acquired after 2 -3 cycles of induction chemotherapy but before the start of high-dose chemotherapy and CT scans/serum tumour marker were compared with the baseline examinations in 23 patients with relapsed germ cell tumours. To evaluate the validity of early response prediction by positron emission tomography, radiological monitoring and serum tumour marker decline, histopathologic response after resection of residual masses and/or the clinical course over 6 months after the end of treatment (relapse vs freedom of progression) were used. Overall, 10 patients (43%) achieved a marker-negative partial remission, three (13%) a markerpositive partial remission, five (22%) a disease stabilization and five (22%) progressed during treatment. Nine patients (39%) remained progression-free over 6 months following treatment, whereas 14 (61%) progressed. The outcome of high-dose chemotherapy was correctly predicted by positron emission tomography/CT scan/serum tumour marker in 91/59/48%. Eight patients with a favourably predicted outcome by CT scans plus serum tumour marker but a positive positron emission tomography prior to high-dose chemotherapy, failed treatment. This results in the following sensitivities/specificities for the prediction of failure of high-dose chemotherapy: positron emission tomography 100/78%; radiological monitoring 43/78%; serum tumour marker 15/100%. The positive and negative predictive values of positron emission tomography were 88 and 100%, respectively. As compared with the prognostic score, positron emission tomography was correctly positive in all patients of the three risk groups who failed treatment. In addition, a negative positron emission tomography correctly predicted a favourable outcome in the good and intermediate group. [ 18 F]fluorodeoxyglucose positron emission tomography imaging can be used to assess response to chemotherapy in patients with relapsed germ cell tumours early in the course of treatment and may help to identify patients most likely to achieve a favourable response to subsequent high-dose chemotherapy. In patients with response to induction chemotherapy according to CT scans or serum tumour marker evaluation, positron emission tomography seems to add information to detect patients with an overall unfavourable outcome. It may also be a valuable addition to the prognostic model particularly in the goo...

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Section: Discussionmentioning

confidence: 99%

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

et al. 2002

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“…Using this criterion, 18 F-FDG PET/CT was found to have a sensitivity of 100%, a specificity of 85% and an accuracy of 88% in identifying responders after the first cycle, while corresponding values after the second cycle were 83%, 94% and 91% 8. After a single pulse of chemotherapy, 18 F-FDG PET was able to predict complete pathological response with a sensitivity of 90% and a specificity of 74% 9.…”

Section: Methodsmentioning

confidence: 99%

¹⁸F-FDG PET/CT Imaging In Oncology

Almuhaideb

Παπαθανασίου

Bomanji

2011

Annals of Saudi Medicine

258

123

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Accurate diagnosis and staging are essential for the optimal management of cancer patients. Positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro- D-glucose integrated with computed tomography (18F-FDG PET/CT) has emerged as a powerful imaging tool for the detection of various cancers. The combined acquisition of PET and CT has synergistic advantages over PET or CT alone and minimizes their individual limitations. It is a valuable tool for staging and restaging of some tumors and has an important role in the detection of recurrence in asymptomatic patients with rising tumor marker levels and patients with negative or equivocal findings on conventional imaging techniques. It also allows for monitoring response to therapy and permitting timely modification of therapeutic regimens. In about 27% of the patients, the course of managment is changed. This review provides guidance for oncologists/ radiotherapists and clinical and surgical specialists on the use of 18F-FDG PET/CT in oncology.

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“…In a paper by Brock et al (2000) FDG PET measurements of MRGlu in brain tumours recorded at 7 days were found to be able to predict ultimate clinical and radiological response to chemotherapy recorded at 2 months. There is now published breast cancer data suggesting that this also may be true at other tumour sites (Smith et al 2000, Schelling et al 2000. The use of 18 F-FDG PET in the neoadjuvant setting may be very important -particularly for identifying non-responders early.…”

Section: Prediction Of Clinical Responsementioning

confidence: 99%

Changes in18F-FDG uptake measured by PET as a pharmacodynamic end-point in anticancer therapy. How far have we got?

Price

2000

Br J Cancer

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There has been a lot of hype over the use of PET in oncology, with hopes that it will provide many answers in clinical research. However, now it has been brought to the attention of clinicians and oncology researchers, it is time to get down to the hard work of exploring its potential and defining its true role.In this edition of the BJC, a paper by Maisey et al (2000) explores the use of 18 F-FDG PET in predicting survival in patients with cancer of the pancreas following systemic chemotherapy. This is one in a series of similar papers that have been published by various groups over the last 4 or 5 years seeking to find the value of FDG PET in measuring response to therapy. So how far have we got? What PET isPositron emission tomography (PET) is a technique which uses radionuclides to label molecules. The molecules can then be imaged in man and this provides quantitative kinetic functional information. The inherent sensitivity and specificity of PET methodology is the most important strength of the technique. Its sensitivity is unrivalled and it can be used to image molecular interactions and pathways, providing quantitative kinetic information down to the sub-pico molar level (Jones, 1996). It lacks the spatial resolution of MRI or CT, but as it is unrivalled in its specificity and kinetic sensitivity, it has a huge future for translation research in oncology (Price, 1997).Molecular imaging using PET is now being developed to assess in vivo pharmacokinetics and pharmacodynamics in oncology (Young et al, 1999a;Saleem et al, 2000). However, currently few groups internationally have the range of expertise in radiochemistry, data analysis, bio-mathematical modelling and kinetic analysis to advance and exploit the technique for these purposes, so progress has been slow. PET methodology is better developed in neurology and psychiatry, but it is still in its infancy in oncology. Current diagnostic use of PETTo most of the oncology community, PET is understood to be static 18 F-FDG images of tumours. This is because the vast majority of work that has been performed in PET in oncology has been using 18 F-FDG. FDG (fluorodeoxyglucose) is an analogue of glucose which is taken up into cells by GLUT 1 transporters and trapped, as it is not metabolized by hexokinase. When FDG is labelled with fluorine-18, its kinetics can be imaged with PET and the resultant signal indicates glucose uptake and trapping. If static images are taken at a certain time (say 45 min post-injection) then images show hot-spots in tumours. Much of the work over the last 10 years has looked at the value of FDG as a diagnostic tool. This is on the basis that FDG is preferentially taken up into tumour cells and so from the differential uptake one can define malignant vs non-malignant disease. There are controversies in its use in diagnosis and to what extent it can replace conventional anatomical imaging (Price, 2000).Cameras for whole-body imaging have been developed in the last few years and so patient scanning can produce a 'soft tissue bone scan'....

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Positron Emission Tomography Using [¹⁸F]Fluorodeoxyglucose for Monitoring Primary Chemotherapy in Breast Cancer

Cited by 482 publications

References 25 publications

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

¹⁸F-FDG PET/CT Imaging In Oncology

Changes in18F-FDG uptake measured by PET as a pharmacodynamic end-point in anticancer therapy. How far have we got?

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Positron Emission Tomography Using [18F]Fluorodeoxyglucose for Monitoring Primary Chemotherapy in Breast Cancer

Cited by 482 publications

References 25 publications

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

Early prediction of treatment response to high-dose salvage chemotherapy in patients with relapsed germ cell cancer using [18F]FDG PET

18F-FDG PET/CT Imaging In Oncology

Changes in18F-FDG uptake measured by PET as a pharmacodynamic end-point in anticancer therapy. How far have we got?

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Positron Emission Tomography Using [¹⁸F]Fluorodeoxyglucose for Monitoring Primary Chemotherapy in Breast Cancer

¹⁸F-FDG PET/CT Imaging In Oncology