Use of PERCIST for Prediction of Progression-Free and Overall Survival After Radioembolization for Liver Metastases from Pancreatic Cancer

Michl, Marlies; Lehner, S.; Paprottka, Philipp M.; Ilhan, Harun; Bartenstein, Peter; Heinemann, Volker; Boeck, Stefan; Albert, Nathalie L.; Fendler, Wolfgang P.

doi:10.2967/jnumed.115.165613

Cited by 24 publications

(18 citation statements)

References 28 publications

(53 reference statements)

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“…Firstly, we used the single-lesion method according to Wahl et al [29], which was shown to be superior to the five-lesion method [22,30]. Secondly, in accordance to Fendler et al, we used peak standardized uptake value corrected for body weight (SUV peak ) instead of lean body mass corrected SUV (SUL peak) as proposed by PERCIST 1.0, because the main objective is the percentage change of SUV from baseline to follow-up imaging and should therefore not be a significant confounder [31]. Riedl et al could also show that response classification was unchanged when SUV max was used instead of SUL peak in patients with metastatic breast cancer [22].…”

Section: Discussionmentioning

confidence: 99%

“…To assess treatment response by mPERCIST change in peak standardized uptake value (SUV peak ) was measured in the tumor region with the highest radiotracer uptake, which describes the average SUV computed in a fixed 1-mL sphere recommended by PERCIST instead of the widely used single-pixel maximum standardized uptake value (SUV max ) to avoid noise errors [18,29]. In a slight modification to the PERCIST 1.0 criteria, the quantitative PET-parameter was adjusted to body weight (SUV peak in g/mL) rather than the body surface area (SUL peak ), as previously described by Fendler et al for the single most active lesion in the patient at baseline, 3 month and 6 month follow-up [31]. A 1 mL spherical VOI was placed at the focus of the single active lesion and the highest SUV peak value was computed automatically.…”

Section: Mpercist and Other Pet-parametersmentioning

confidence: 99%

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18F-FDG-PET/CT in Patients with Advanced, Radioiodine Refractory Thyroid Cancer Treated with Lenvatinib

Ahmaddy

Burgard

Beyer

et al. 2021

Cancers

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Background: The tyrosine kinase inhibitor (TKI) Lenvatinib represents one of the most effective therapeutic options in patients with advanced radioiodine refractory differentiated thyroid carcinoma (DTC). We aimed to assess the role of 2-deoxy-2-[18F] fluoro-D-glucose positron-emission-tomography/computed-tomography (18F-FDG-PET/CT) in the monitoring of functional tumor response compared to morphological response. Methods: In 22 patients, a modified Positron Emission Tomography Response Criteria In Solid Tumors (mPERCIST) evaluation before treatment with Lenvatinib and at 3 and 6 month follow up was performed. Further PET-parameters and morphologic tumor response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 were assessed and their prediction of progression-free survival (PFS) and disease-specific survival (DSS) was evaluated. Results: Most patients were rated stable in morphological evaluation and progressive using a metabolic response. All patients who responded to therapy through RECIST showed a decline in nearly all Positron Emission Tomography (PET)-parameters. For both time-points, non-responders according to mPERCIST showed significantly lower median PFS and DSS, whereas according to RECIST, only DSS was significantly lower. Conclusion: Tumor response assessment by 18F-FDG-PET outperforms morphological response assessment by CT in patients with advanced radioiodine refractory DTC treated with Lenvatinib, which seems to be correlated with clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Mpercist and Other Pet-parametersmentioning

confidence: 99%

18F-FDG-PET/CT in Patients with Advanced, Radioiodine Refractory Thyroid Cancer Treated with Lenvatinib

Ahmaddy

Burgard

Beyer

et al. 2021

Cancers

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“…They found 35% of complete response, 6% of partial response, and 59% of disease progression. And the median overall survival was 8.8 months [ 21 ]. However, none of these patients had PACC.…”

Section: Discussionmentioning

confidence: 99%

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres

Nasser

Filho

Affonso

et al. 2017

Case Reports in Hepatology

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Background Pancreatic acinar cell carcinoma (PACC) is a rare tumor. Surgical resection is the treatment of choice when feasible, but there are no clear recommendations for patients with advanced disease. Liver-directed therapy with Y-90 selective internal radiation therapy (SIRT) has been used to treat hepatic metastases from pancreatic tumors. We describe a case of PACC liver metastases treated with SIRT. Case Report 59-year-old man was admitted with an infiltrative, solid lesion in pancreatic tail diagnosed as PACC. Lymph nodes in the hepatic hilum were enlarged, and many metastatic liver nodules were observed. After partial pancreatectomy, the left and right lobes of the liver were separately treated with Y-90 resin microspheres. Follow-up imaging revealed that all hepatic nodules shrank by at least 50%, and 3 nodules disappeared completely. Lipase concentration was 8407 U/L at baseline, rose to 12,705 U/L after pancreatectomy, and declined to 344 U/L after SIRT. Multiple rounds of chemotherapy in the subsequent year shrank the hepatic tumors further; disease then progressed, but a third line of chemotherapy shrank the tumors again, 16 months after SIRT treatment. Conclusion SIRT had a positive effect on liver metastases from PACC. In conjunction with systemic therapy, SIRT can achieve sustained disease control.

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“…A change in SUVpeak and total lesion glycolysis predicted overall survival (p = 0.039; hazard ratio [HR], 0.24; 95% confidence interval [CI], 0.06-0.93), progression-free survival (p = 0.016; HR, 0.15; 95% CI, 0.03-0.69), and time to intrahepatic progression (p = 0.010; HR, 0.16; 95% CI, 0.04-0.65) [24]. Interestingly, in the same study, summed baseline CT diameter of less than 8 cm for the 2 largest liver metastases predicted time to intrahepatic progression (p = 0.013; HR, 0.21; 95% CI, 0.06-0.72) but did not predict overall or progression-free survival [24]. Overall, the body of evidence supports that a reduction of FDG avidity in early PET (4 weeks) might be useful to predict the further outcome of the patients.…”

Section: Fdg-pet-ctmentioning

confidence: 99%

Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice

et al. 2020

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Interventional radiology plays an important and increasing role in cancer treatment. Follow-up is important to be able to assess treatment success and detect locoregional and distant recurrence and recommendations for follow-up are needed. At ECIO 2018, a joint ECIO-ESOI session was organized to establish follow-up recommendations for oncologic intervention in liver, renal, and lung cancer. Treatments included thermal ablation, TACE, and TARE. In total five topics were evaluated: ablation in colorectal liver metastases (CRLM), TARE in CRLM, TACE and TARE in HCC, ablation in renal cancer, and ablation in lung cancer. Evaluated modalities were FDG-PET-CT, CT, MRI, and (contrast-enhanced) ultrasound. Prior to the session, five experts were selected and performed a systematic review and presented statements, which were voted on in a telephone conference prior to the meeting by all panelists. These statements were presented and discussed at the ECIO-ESOI session at ECIO 2018. This paper presents the recommendations that followed from these initiatives. Based on expert opinions and the available evidence, follow-up schedules were proposed for liver cancer, renal cancer, and lung cancer. FDG-PET-CT, CT, and MRI are the recommended modalities, but one should beware of false-positive signs of residual tumor or recurrence due to inflammation early after the intervention. There is a need for prospective preferably multicenter studies to validate new techniques and new response criteria. This paper presents recommendations that can be used in clinical practice to perform the follow-up of patients with liver, lung, and renal cancer who were treated with interventional locoregional therapies.

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Use of PERCIST for Prediction of Progression-Free and Overall Survival After Radioembolization for Liver Metastases from Pancreatic Cancer

Cited by 24 publications

References 28 publications

18F-FDG-PET/CT in Patients with Advanced, Radioiodine Refractory Thyroid Cancer Treated with Lenvatinib

18F-FDG-PET/CT in Patients with Advanced, Radioiodine Refractory Thyroid Cancer Treated with Lenvatinib

Liver Metastases in Pancreatic Acinar Cell Carcinoma Treated with Selective Internal Radiation Therapy with Y-90 Resin Microspheres

Follow-up after radiological intervention in oncology: ECIO-ESOI evidence and consensus-based recommendations for clinical practice

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