Prognostic Value of 18F-FDG PET/CT in Patients with Malignant Pleural Mesothelioma

Lee, S. T.; Ghanem, Mazen A.; Herbertson, Rebecca; Berlangieri, Salvatore U; Byrne, Amanda; Tabone, K.; Mitchell, Paul; Knight, Simon; Feigen, M.; Scott, Andrew M.

doi:10.1007/s11307-009-0203-6

Cited by 34 publications

(21 citation statements)

References 22 publications

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“…For instance, the presence of metastatic disease on PET-CT has, not surprisingly, been shown to be associated with poorer survival (15). Furthermore, one study showed that patients who had an SUVmax greater than 10 had decreased survival (16).…”

Section: Discussionmentioning

confidence: 99%

F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

Leod

Stobo

O’Rourke

et al. 2015

Rep Radiother Oncol

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Background: Positron emission tomography computerized tomography (PET-CT) is useful in radiotherapy planning for lung cancer. However, its role in malignant pleural mesothelioma (MPM) is unknown. Objectives: This exploratory study investigated the possible role for PET-CT in radiotherapy planning for MPM. Patients and Methods: Patients receiving radiotherapy for the treatment of pain in MPM, had fluorodeoxyglucose (FDG) PET-CT scanning in addition to their standard CT scan. PET-CT images were then fused with CT planning images, termed Planning-PET-CT. Target volume delineation was undertaken first using CT and subsequently incorporated Planning-PET-CT. Planning treatment volume (PTV), conformity index (CI), mean distance to conformity (MDC), center of gravity distance (CGD) and standard uptake values (SUV) were examined. Results: Sixteen patients were recruited into the study. PET-CT upstaged nine patients. No association between SUV max and either survival or pain response was seen. Volumes contoured using Planning-PET-CT differed markedly from those outlined using CT alone as shown by the following parameters: CI = 0.3 (0.24 -0.38). ). The median percentage of over contouring was 44.00% (34.33 -72.50) with 46.67% under contoured (34.00 -55.00). Conclusions: PET-CT alters the position of the PTV in MPM and upstaged a proportion of patients. Further work to elucidate the role of Planning-PET-CT in target volume definition is justified.

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Section: Discussionmentioning

confidence: 99%

F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

Leod

Stobo

O’Rourke

et al. 2015

Rep Radiother Oncol

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“…In a retrospective review [37] of FDG-PET/CT performed in patients with biopsy-proven MPM, mean SUV max of primary MPM in patients with metastatic disease was significantly higher than in patients with MPM without metastatic disease (pG0.05). Longer survival was noted in patients without metastases (pG0.05).…”

Section: Prognosis Defined By Fdg Uptake Of Tumormentioning

confidence: 96%

Current Evidence Base of FDG-PET/CT Imaging in the Clinical Management of Malignant Pleural Mesothelioma: Emerging Significance of Image Segmentation and Global Disease Assessment

et al. 2010

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Increasingly, integrated positron emission tomography-computed tomography (PET/CT) imaging is playing a crucial role in the assessment of patients with known or suspected malignant pleural mesothelioma (MPM). Based on the data reported in the literature, this combined modality is likely to become the instrument of choice for examining patients of MPM. The research on this subject has focused on the following five domains: (1) differentiation of MPM from other benign pleural diseases, (2) preoperative staging for the selection of appropriate candidates for surgery, (3) evaluation for therapy response and post-treatment surveillance for recurrence, (4) prognostication based upon the intensity of 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) uptake, and (5) planning of radiotherapy. These represent the bases for critical decision making in the management of mesothelioma, and FDG-PET/CT offers potential advantages over conventional CT imaging and thus can play a pivotal role in this regard. Optimal characterization of this potentially fatal disease with a high negative predictive value for MPM, superior capability for cancer staging initially and at the later course of disease, and ability for measuring therapeutic response and the precise determination of the target volume for radiotherapy planning represent distinct advantages of this promising molecular imaging tool. In this communication, we have explored the promising role of integrated FDG-PET/CT in the overall management of this serious malignancy. From the available data, the major role of PET-CT at present appears to be in the preoperative disease staging, response to treatment assessment, and post-treatment disease surveillance of MPM. In all these three areas, PET-CT convincingly shows better results than conventional anatomical imaging alone and thereby can aid in exploring novel therapeutic approaches. Disease prognosis and radiotherapy planning are evolving areas where this modality has demonstrated significant promise, but this has to be investigated further. The differentiating of MPM from benign pleural disease is a challenging issue; though in limited studies, it has shown promising results, single standardized uptake value (SUV) cutoff technique cannot be the optimal way for this purpose. Dual time point and delayed imaging helps further in this setting; however, more data require to be accrued in this area. We, in this review, have also discussed the feasibility of a new method of image segmentation based on an iterative thresholding algorithm, which permits definition of the boundaries of lesions based on PET images alone to provide lesional metabolically active tumor volumes, lesional partial volume corrected SUV (PVC-SUV) measurements, lesional PVC metabolic burden (PVC-MB) (calculated as the product of lesional MVP and lesional PVC-SUV), and whole body metabolic burden (WBMB) (calculated as the sum of lesional PVC-MB of all lesions). This global disease assessment, we believe, will be the way forward for assessing this malignancy with a non-invasive...

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“…The first was reported by Tan et al and involved the evaluation of 44 patients using PET/CT after multimodality therapy for MPM (Tan, 2010). The other study was reported by Lee and was a retrospective study involving 46 patients who were evaluated using PET/CT for staging or re-staging after therapy for MPM (Lee et al, 2009). Both studies concluded that detecting extrathoracic metastases using FDG-PET/CT indicates poor prognosis in patients with MPM.…”

Section: Pet For Restaging and Survivalmentioning

confidence: 99%

Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma

Kimura¹,

Kudoh²,

Hirata³

2012

Positron Emission Tomography - Current Clinical and Research Aspects

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Prognostic Value of 18F-FDG PET/CT in Patients with Malignant Pleural Mesothelioma

Abstract: Detection of extrathoracic metastases on FDG-PET/CT and nonepithelioid histopathology are poor prognostic indicators in patients with MM.

Cited by 34 publications

References 22 publications

F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

F-18 FDG PET-CT Influences Target Delineation When Combined With Standard CT-Based Radiotherapy Planning in the Palliative Setting in Malignant Pleural Mesothelioma; an Exploratory Study

Current Evidence Base of FDG-PET/CT Imaging in the Clinical Management of Malignant Pleural Mesothelioma: Emerging Significance of Image Segmentation and Global Disease Assessment

Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma

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