Role of¹⁸F-FDG PET in Assessment of Response in Non–Small Cell Lung Cancer

Abstract

Despite recognized limitations, structural imaging with CT remains the standard technique for evaluating the response of lung cancer to both chemotherapy and radiotherapy. This evaluation has become increasingly important with the advent of neoadjuvant therapy before surgery. The high uptake of 18 F-FDG in most lung cancers and the demonstration that successful treatment reduces uptake have led to increasing enthusiasm for the use of PET and PET/CT to assess the therapeutic response. In this review, theoretic considerations and current evidence supporting the role of 18 F-FDG PET are discussed.

18F-FDG PET as a Surrogate Biomarker in Non–Small Cell Lung Cancer Treated with Erlotinib: Newly Identified Lesions Are More Informative Than Standardized Uptake Value

“…This utility hinges on a reliable and validated link between early 18 F-FDG PET response and improved clinical outcome. Although such evidence is growing for several tumors, including lung cancer (3), and with treatments including radiotherapy and chemotherapy (4,5), it may not hold uniformly across indications and therapies. Here, using data from 2 global multicenter, phase II studies of second-or third-line non-small cell lung cancer (NSCLC) patients treated with a targeted agent, we investigate the extent to which survival duration can be predicted with 18 F-FDG PET information obtained at baseline and early in treatment.…”

Repeatability of 18F-FDG Uptake Measurements in Tumors: A Metaanalysis

“…Key Words: 18 PETwi th 18 F-FDG has gained an important role in the clinical setting to detect and stage malignancies and assess treatment response (1)(2)(3)(4)(5)(6). In the research setting, PET is increasingly being used to study early changes of biologic effects during and after anticancer treatment (7)(8)(9)(10).…”

Prediction of survival and cancer recurrence using F-18 FDG PET/CT in patients with surgically resected early stage (Stage I and II) non-small cell lung cancer

“…In a number of reports, 5 year survival rates for patients with stage I disease range 60~75 %, while for stage II disease five-year survival rates vary from 36~60 % [2-6]. However, the recurrence rate after curative resection still remains high and approximately half of the patients may relapse and die within 5 years, and majority of these relapses are due to distant metastasis and occur within 2 years after complete resection [7,8].Fluorine-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) has been established as a standard imaging technique in staging, treatment monitoring, prediction of survival after treatment, and follow-up of NSCLC patients [9][10][11][12][13][14][15]. Maximal standardized uptake value (SUV max ) measured by F-18 FDG PET is a semiquantitative index reflecting tumor metabolism and activities.…”

“…Fluorine-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) has been established as a standard imaging technique in staging, treatment monitoring, prediction of survival after treatment, and follow-up of NSCLC patients [9][10][11][12][13][14][15]. Maximal standardized uptake value (SUV max ) measured by F-18 FDG PET is a semiquantitative index reflecting tumor metabolism and activities.…”