title: Value of combined interpretation of computed tomography response and positron emission tomography response for prediction of prognosis after neoadjuvant chemotherapy in non-small cell lung cancer.
abstract: BACKGROUND
  The purpose of this study was to assess the value of tumor response evaluation using combined interpretation of [18F] fluorodeoxyglucose positron emission tomography (PET) and computed tomography (CT) for the prediction of clinical outcome and pathologic response in patients with stage III non-small cell lung cancer who underwent neoadjuvant chemotherapy followed by surgery.
  
  
  METHODS
  This study was approved by the Institutional Review Board with a waiver of informed consent. Forty-four consecutive patients (M:F = 32:12; mean age, 60.7 years) with locally advanced non-small cell lung cancer received neoadjuvant chemotherapy followed by curative surgery. Time to recurrence (TTR) was stratified by radiologic, metabolic, and radiologic-metabolic response using the Kaplan-Meier method. The accuracy of radiologic, metabolic, and radiologic-metabolic response criteria for the prediction of pathologic response was evaluated.
  
  
  RESULTS
  Radiologic-metabolic responders had a longer TTR than nonresponders (mean TTR, 58.7 months versus 22.3 months, p = 0.001 with criteria of >or=30% reduction of size and >or=50% reduction of [maximum standardized uptake value] SUVmax and mean TTR, 49.4 months versus 23.5 months, p = 0.022 with criteria of >or=30% reduction of size and >or=25% reduction of SUVmax, respectively). The TTR of radiologic responders (criteria of >or=30% reduction of size) and metabolic responders (criteria of >or=25% reduction of SUVmax) was not different from the TTR of nonresponders (p > 0.05). The accuracy for the prediction of pathologic response was 70% in radiologic responders, 52 to 75% in metabolic responders, and 73 to 82% in radiologic-metabolic responders.
  
  
  CONCLUSIONS
  Tumor response evaluation using combined interpretation of [18F] fluorodeoxyglucose-PET and CT was more effective than single interpretation of CT response or PET response alone for the prediction of tumor recurrence and pathologic response.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, Republic of Korea.
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Lee
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kang
authors.forename: Bo Gun
authors.initials: BG
authors.lastname: Jang
authors.forename: Doo Hyun
authors.initials: DH
authors.lastname: Chung
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Lee
authors.forename: Keon Wook
authors.initials: KW
authors.lastname: Kang
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018287:Carcinoma, Large Cell / Q000000981:diagnostic imaging / Q000188:drug therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18