Correlation of FDG-PET findings with histopathology in the assessment of response to induction chemoradiotherapy in non-small cell lung cancer.
OBJECTIVE
The objective of this study was to evaluate the ability of FDG-PET to predict the response of primary tumour and nodal disease to preoperative induction chemoradiotherapy in patients with non-small cell lung cancer (NSCLC).


METHODS
FDG-PET studies were performed before and after completion of chemoradiotherapy prior to surgery in 26 patients with NSCLC. FDG-PET imaging was performed at 1 h (early) and 2 h (delayed) after injection. Semi-quantitative analysis was performed using the standardised uptake value (SUV) at the primary tumour. Percent change was calculated according to the following equation: [see text]. Based on histopathological analysis of the specimens obtained at surgery, patients were classified as pathological responders or pathological non-responders. The clinical nodal stage on the post-chemoradiotherapy PET scan was visually determined and compared with the final pathological stage.


RESULTS
Eighteen patients were found to be pathological responders and eight to be pathological non-responders. SUV(after) values from both early and delayed images in pathological responders were significantly lower than those in pathological non-responders. The percent change values from early and delayed images in the pathological responders were significantly higher than those in the pathological non-responders. The post-chemoradiotherapy PET scan accurately predicted nodal stage in 22 of 26 patients.


CONCLUSIONS
FDG-PET may have the potential to predict response to induction chemoradiotherapy in patients with NSCLC.
Yamamoto
Yuka
Y
Faculty of Medicine, Department of Radiology, Kagawa University, Kita-gun, Kagawa, Japan. yuka@kms.ac.jp
Nishiyama
Yoshihiro
Y
Monden
Toshihide
T
Sasakawa
Yasuhiro
Y
Ohkawa
Motoomi
M
Gotoh
Masashi
M
Kameyama
Kotaro
K
Haba
Reiji
R
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D013997:Time Factors
D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18