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The role of positron emission tomography following radiosurgical treatment of malignant lung lesions.

Abstract：

OBJECTIVE:To establish response patterns in PET following stereotactic body radiotherapy (SBRT) of malignant lung lesions. METHODS:Patients with malignant lung lesions treated with SBRT were retrospectively reviewed. All patients received 40-52 Gy in three to five equal fractions. An independent, blinded radiologist reassessed all 18F-fluoro-deoxy-glucose PET/computed tomography scans to determine the tumor maximum standardized uptake value (SUVmax) and size changes. RESULTS:Thirty-nine patients were included in this study. Of the 47 lesions treated, there were 22 primary and 25 metastatic lung lesions. In total, 86 PET/computed tomography studies were reviewed. The mean SUVmax values decreased markedly and stabilized after 6 months following the treatment of primary lesions. Metastatic lesions showed greater variability, with an overall increase in SUVmax values until 6 months and decrease thereafter. Of the eight local failures, the mean SUVmax and size change from nadir values to biopsy-proven failure were 117 and 215%; however, it was difficult to measure the size of five lesions because of fibrotic changes. Statistical analysis revealed metastatic tumors to be associated with poorer local control (P=0.028). No correlation was found between size or pretreatment SUVmax and outcome. CONCLUSION:Anticipated SUVmax and size patterns following SBRT remain a challenge due to surrounding tissue reactions. Nonetheless, marked SUVmax changes can aid in determining local failure. Increases in size were also observed in local failures; however, localized fibrosis challenges its utility in distinguishing failures from a normal tissue response. A larger series needs to be examined to better establish the correlation of PET responses to overall survival and local control.

journal_name

Nucl Med Commun

journal_title

Nuclear medicine communications

authors

Gill BS,Rivandi AH,Sandhu SP,Jensen LG,Nobiensky PD,Hoh CK,Sandhu AP

doi

10.1097/MNM.0b013e3283512b08

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

607-12

issue

eissn

0143-3636

issn

1473-5628

pii

00006231-201206000-00006

journal_volume

pub_type

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The role of positron emission tomography following radiosurgical treatment of malignant lung lesions.