Benz, Matthias R.;
Czernin, Johannes;
Allen-Auerbach, Martin S.;
Tap, William D.;
Dry, Sarah M.;
Elashoff, David;
Chow, Kira;
Evilevitch, Vladimir;
Eckardt, Jeff J.;
Phelps, Michael E.;
Weber, Wolfgang A.;
Eilber, Fritz C.
FDG-PET/CT Imaging Predicts Histopathologic Treatment Responses after the Initial Cycle of Neoadjuvant Chemotherapy in High-Grade Soft-Tissue Sarcomas
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Medientyp:
E-Artikel
Titel:
FDG-PET/CT Imaging Predicts Histopathologic Treatment Responses after the Initial Cycle of Neoadjuvant Chemotherapy in High-Grade Soft-Tissue Sarcomas
Beteiligte:
Benz, Matthias R.;
Czernin, Johannes;
Allen-Auerbach, Martin S.;
Tap, William D.;
Dry, Sarah M.;
Elashoff, David;
Chow, Kira;
Evilevitch, Vladimir;
Eckardt, Jeff J.;
Phelps, Michael E.;
Weber, Wolfgang A.;
Eilber, Fritz C.
Erschienen:
American Association for Cancer Research (AACR), 2009
Beschreibung:
<jats:title>Abstract</jats:title>
<jats:p>Purpose: In patients with soft-tissue sarcoma (STS), the early assessment of treatment responses is important. Using positron emission tomography/computed tomography (PET/CT) with [18F]fluorodeoxyglucose (FDG), we determined whether changes in tumor FDG uptake predict histopathologic treatment responses in high-grade STS after the initial cycle of neoadjuvant chemotherapy.</jats:p>
<jats:p>Experimental Design: From February 2006 to March 2008, 50 patients with resectable high-grade STS scheduled for neoadjuvant therapy and subsequent tumor resection were enrolled prospectively. FDG-PET/CT before (baseline), after the first cycle (early follow-up), and after completion of neoadjuvant therapy (late follow-up) was done. Tumor FDG uptake and changes were measured by standardized uptake values. Histopathologic examination of the resected specimen provided an assessment of treatment response. Patients with ≥95% pathologic necrosis were classified as treatment responders. FDG-PET/CT results were compared with histopathologic findings.</jats:p>
<jats:p>Results: At early follow-up, FDG uptake decreased significantly more in 8 (16%) responders than in the 42 (84%) nonresponders (−55% versus −23%; P = 0.002). All responders and 14 of 42 nonresponders had a ≥35% reduction in standardized uptake value between baseline and early follow-up. Using a ≥35% reduction in FDG uptake as early metabolic response threshold resulted in a sensitivity and specificity of FDG-PET for histopathologic response of 100% and 67%, respectively. Applying a higher threshold at late follow-up improved specificity but not sensitivity. CT had no value at response prediction.</jats:p>
<jats:p>Conclusion: A 35% reduction in tumor FDG uptake at early follow-up is a sensitive predictor of histopathologic tumor response. Early treatment decisions such as discontinuation of chemotherapy in nonresponding patients could be based on FDG-PET criteria.</jats:p>