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Clinical Trial
. 2011 Jun;38(6):1059-63.
doi: 10.1007/s00259-010-1706-8. Epub 2011 Jan 6.

18F-FDG PET during stereotactic body radiotherapy for stage I lung tumours cannot predict outcome: a pilot study

Erwin M Wiegman  1 , Jan Pruim, Jan F Ubbels, Harry J M Groen, Johannes A Langendijk, Joachim Widder
Affiliations
Clinical Trial

18F-FDG PET during stereotactic body radiotherapy for stage I lung tumours cannot predict outcome: a pilot study

Erwin M Wiegman et al. Eur J Nucl Med Mol Imaging. 2011 Jun.

Abstract

Purpose: (18)F-Fluorodeoxyglucose positron emission tomography (FDG PET) has been used to assess metabolic response several months after stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer. However, whether a metabolic response can be observed already during treatment and thus can be used to predict treatment outcome is undetermined.

Methods: Ten medically inoperable patients with FDG PET-positive lung tumours were included. SBRT consisted of three fractions of 20 Gy delivered at the 80% isodose at days 1, 6 and 11. FDG PET was performed before, on day 6 immediately prior to administration of the second fraction of SBRT and 12 weeks after completion of SBRT. Tumour metabolism was assessed semi-quantitatively using the maximum standardized uptake value (SUV(max)) and SUV(70%).

Results: After the first fraction, median SUV(max) increased from 6.7 to 8.1 (p = 0.07) and median SUV(70%) increased from 5.7 to 7.1 (p = 0.05). At 12 weeks, both median SUV(max) and median SUV(70%) decreased by 63% to 3.1 (p = 0.008) and to 2.5 (p = 0.008), respectively.

Conclusion: SUV increased during treatment, possibly due to radiation-induced inflammation. Therefore, it is unlikely that (18)F-FDG PET during SBRT will predict treatment success.

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Figures

Fig. 1
Fig. 1
Absolute SUVmax before, after the first fraction and 12 weeks after completion of SBRT. SUVmax increased after the first fraction (p = 0.07) and decreased significantly 12 weeks after SBRT (p = 0.008)
Fig. 2
Fig. 2
Sequential axial PET (upper row), CT (middle row) and fused PET/CT (lower row) images of patient 3, before (a), after the first fraction (b) and 12 weeks after SBRT (c). SUVmax increased from 6.3 to 8.3 after the first fraction. At 12 weeks SUVmax decreased to 1.3 (CMR) and was considered a partial response according to RECIST criteria
See this image and copyright information in PMC

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