Universität zu Köln

Kahraman, Deniz, Scheffler, Matthias ORCID: 0000-0002-9031-1368, Zander, Thomas, Nogova, Lucia, Lammertsma, Adriaan A., Boellaard, Ronald ORCID: 0000-0002-0313-5686, Neumaier, Bernd ORCID: 0000-0001-5425-3116, Ullrich, Roland T., Holstein, Arne, Dietlein, Markus, Wolf, Juergen and Kobe, Carsten (2011). Quantitative Analysis of Response to Treatment with Erlotinib in Advanced Non-Small Cell Lung Cancer Using F-18-FDG and 3 '-Deoxy-3 '-F-18-Fluorothymidine PET. J. Nucl. Med., 52 (12). S. 1871 - 1878. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

The purpose of this study was to evaluate the relevance for the prediction of clinical benefit of first-line treatment with erlotinib using different quantitative parameters for PET with both F-18-FDG and 3'-deoxy-3'-F-18-fluorothymidine (F-18-FLT) in patients with advanced non-small cell lung cancer. Methods: Data were used from a prospective trial involving patients with untreated stage IV non-small cell lung cancer. F-18-FDG PET and F-18-FLT PET were performed before and 1 (early) and 6 (late) weeks after erlotinib treatment. Several quantitative standardized uptake values (SUVs) using different definitions of volumes of interest with varying isocontours (maximum SUV [SUVmax], 2-dimensional peak SUV [SUV2Dpeak], 3-dimensional [3D] peak SUV [SUV3Dpeak], 3D isocontour at 50% of the maximum pixel value [SUV50], 3D isocontour at 50% adapted for background [SUVA50], 3D isocontour at 41% of the maximum pixel value adapted for background [SUVA41], 3D isocontour at 70% of the maximum pixel value [SUV70], 3D isocontour at 70% adapted for background [SUVA70], and relative SUV threshold level [SUVRTL]) and metabolically active volume measurements were obtained in the hottest single tumor lesion and in the sum of up to 5 lesions per scan in 30 patients. Metabolic response was defined as a minimum reduction of 30% in each of the different SUVs and as a minimum reduction of 45% in metabolically active volume. Progression-free survival (PFS) was compared between patients with and without metabolic response measured with each of the different parameters, using Kaplan-Meier statistics and a log-rank test. Results: Patients with a metabolic response on early F-18-FDG PET and F-18-FLT PET in the hottest single tumor lesion as well as in the sum of up to 5 lesions per scan had a significantly longer PFS, regardless of the method used to calculate SUV. However, the highest significance was obtained for SUVmax, SUV50, SUVA50, and SUVA41. Patients with a metabolic response measured by SUVmax and SUV3Dpeak on late F-18-FDG PET in the hottest single tumor lesion had a significantly longer PFS. Furthermore, Kaplan-Meier analyses showed a strong association between PFS and response seen by metabolically active volume, measured either in early F-18-FLT or in late F-18-FDG. Conclusion: Early F-18-FDG PET and F-18-FLT PET can predict PFS regardless of the method used for SUV calculation. However, SUVmax, SUV50, SUVA50, and SUVA41 measured with F-18-FDG might be the best robust SUV to use for early response prediction. Metabolically active volume measurement in early F-18-FLT PET and late F-18-FDG PET may have an additional predictive value in monitoring response in patients with advanced non-small cell lung cancer treated with erlotinib.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kahraman, Deniz UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheffler, Matthias UNSPECIFIED orcid.org/0000-0002-9031-1368 UNSPECIFIED Zander, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Nogova, Lucia UNSPECIFIED UNSPECIFIED UNSPECIFIED Lammertsma, Adriaan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boellaard, Ronald UNSPECIFIED orcid.org/0000-0002-0313-5686 UNSPECIFIED Neumaier, Bernd UNSPECIFIED orcid.org/0000-0001-5425-3116 UNSPECIFIED Ullrich, Roland T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Holstein, Arne UNSPECIFIED UNSPECIFIED UNSPECIFIED Dietlein, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Juergen UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-484050
DOI:	10.2967/jnumed.111.094458
Journal or Publication Title:	J. Nucl. Med.
Volume:	52
Number:	12
Page Range:	S. 1871 - 1878
Date:	2011
Publisher:	SOC NUCLEAR MEDICINE INC
Place of Publication:	RESTON
ISSN:	1535-5667
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; EARLY PREDICTION; ROI DEFINITION; BREAST-CANCER; TUMOR; QUANTIFICATION; PROLIFERATION; GEFITINIB Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48405