Time and Again, Children Resemble Their Parents

Hicks, Rodney J.

doi:10.2967/jnumed.108.052142

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Careful studies from Dooms et al have shown that metastatic-tumor-involved mediastinal nodal pathology and clinical behavior are well predicted by changes in SUV and absolute SUV in the primary lung cancer and by qualitative visual assessments of nodal status (66,142). This is in part because ''child'' metastases biologically resemble their ''parents'' (143,144).…”

Section: How Many Lesions To Assess?mentioning

confidence: 99%

PERCISTence: Strength or Stubbornness? (perspective on “From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors” J Nucl Med. 2009;50(suppl 1):122S–150S)

Hicks

Hoekstra

2020

J Nucl Med

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History is the unfolding of miscalculation.-Barbara W. Tuchman, American historian In celebrating 60 years of JNM, it is hard to conceive of molecular imaging without 18 F-FDG PET, particularly in oncology. Recognizing the importance of metabolic reprogramming in malignant transformation, seminal studies demonstrated the utility of 18 F-FDG PET for detecting cancer and assessing response to therapy. Even using a single fi eld of view, preliminary studies on breast cancer, for example, demonstrated the prognostic value of a reduction in 18 F-FDG uptake and the ability of PET to predict benefi t earlier and better than conventional imaging (1). Wholebody imaging subsequently allowed global assessment of cancer distribution before and after therapeutic intervention. No molecular imaging, radiology, or oncology meeting these days is not replete with serial maximumintensity-projection images demonstrating therapeutic effi cacy.Despite widespread acceptance of the power of 18 F-FDG PET to diagnose and follow cancer clinically, its adoption and regulatory recognition as a response assessment tool in clinical trials are still limited compared with anatomic imaging as codifi ed in RECIST. Recognition that adoption of 18 F-FDG PET as a surrogate biomarker of survival depends on validated and reproducible defi nitions of response led the European Organization for Research and Treatment of Cancer to develop therapeutic response guidelines (2). Competing with this attempt, scoring systems based on semiqualitative assessment of 18 F-FDG PET after treatment were developed and implemented, such as in lymphoma (3). The

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Section: How Many Lesions To Assess?mentioning

confidence: 99%

PERCISTence: Strength or Stubbornness? (perspective on “From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors” J Nucl Med. 2009;50(suppl 1):122S–150S)

Hicks

Hoekstra

2020

J Nucl Med

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From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors

et al. 2009

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The purpose of this article is to review the status and limitations of anatomic tumor response metrics including the World Health Organization (WHO) criteria, the Response Evaluation Criteria in Solid Tumors (RECIST), and RECIST 1.1. This article also reviews qualitative and quantitative approaches to metabolic tumor response assessment with 18 F-FDG PET and proposes a draft framework for PET Response Criteria in Solid Tumors (PERCIST), version 1.0. Methods: PubMed searches, including searches for the terms RECIST, positron, WHO, FDG, cancer (in-cluding specific types), treatment response, region of interest, and derivative references, were performed. Abstracts and articles judged most relevant to the goals of this report were reviewed with emphasis on limitations and strengths of the anatomic and PET approaches to treatment response assessment. On the basis of these data and the authors' experience, draft criteria were formulated for PET tumor response to treatment.Results: Approximately 3,000 potentially relevant references were screened. Anatomic imaging alone using standard WHO, RECIST, and RECIST 1.1 criteria is widely applied but still has limitations in response assessments. For example, despite effective treatment, changes in tumor size can be minimal in tumors such as lymphomas, sarcoma, hepatomas, mesothelioma, and gastrointestinal stromal tumor. CT tumor density, contrast enhancement, or MRI characteristics appear more informative than size but are not yet routinely applied. RECIST criteria may show progression of tumor more slowly than WHO criteria. RECIST 1.1 criteria (assessing a maximum of 5 tumor foci, vs. 10 in RECIST) result in a higher complete response rate than the original RECIST criteria, at least in lymph nodes. Variability appears greater in assessing progression than in assessing response. Qualitative and quantitative approaches to 18 F-FDG PET response assessment have been applied and require a consistent PET methodology to allow quantitative assessments. Statistically significant changes in tumor standardized uptake value (SUV) occur in careful test-retest studies of high-SUV tumors, with a change of 20% in SUV of a region 1 cm or larger in diameter; however, medically relevant beneficial changes are often associated with a 30% or greater decline. The more extensive the therapy, the greater the decline in SUV with most effective treatments. Important components of the proposed PERCIST criteria include assessing normal reference tissue values in a 3-cm-diameter region of interest in the liver, using a consistent PET protocol, using a fixed small region of interest about 1 cm 3 in volume (1.2-cm diameter) in the most active region of metabolically active tumors to minimize statistical variability, assessing tumor size, treating SUV lean measurements in the 1 (up to 5 optional) most metabolically active tumor focus as a continuous variable, requiring a 30% decline in SUV for ''response,'' and deferring to RECIST 1.1 in cases that do not have 18 F-FDG avidity or are technically unsuitable...

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Time and Again, Children Resemble Their Parents

Cited by 2 publications

References 12 publications

PERCISTence: Strength or Stubbornness? (perspective on “From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors” J Nucl Med. 2009;50(suppl 1):122S–150S)

PERCISTence: Strength or Stubbornness? (perspective on “From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors” J Nucl Med. 2009;50(suppl 1):122S–150S)

From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors

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