title: 18F-fluorodeoxyglucose positron emission tomography in the management of patients with thymic epithelial tumors.
abstract: OBJECTIVE
  There are limited data regarding the role of (18)F-fluorodeoxyglucose positron emission tomography ([(18)F]-FDG PET) imaging in management of patients with thymic epithelial tumors (TET). The primary objective of this study was to assess the usefulness of early [(18)F]-FDG PET to monitor treatment efficacy and its correlation with Response Evaluation Criteria in Solid Tumors (RECIST) in patients with TETs.
  
  
  METHODS
  [(18)F]-FDG PET/computed tomographic (CT) scans were conducted at baseline and after 6 weeks of treatment in patients enrolled in two phase II and one phase I/II clinical trials. On the basis of data from other solid tumors, metabolic response was defined as a reduction of [(18)F]-FDG uptake by more than 30% as assessed by average standardized uptake values (SUV) of up to five most metabolically active lesions.
  
  
  RESULTS
  Fifty-six patients with unresectable Masaoka stage III or IV TETs were included. There was a close correlation between early metabolic response and subsequent best response using RECIST (P < 0.0001-0.0003): sensitivity and specificity for prediction of best response were 95% and 100%, respectively. Metabolic responders had significantly longer progression-free survival (median, 11.5 vs. 4.6 months; P = 0.044) and a trend toward longer overall survival (median, 31.8 vs. 18.4 months; P = 0.14) than nonresponders. [(18)F]-FDG uptake was significantly higher in thymic carcinoma than in thymoma (P = 0.0004-0.0010).
  
  
  CONCLUSIONS
  In patients with advanced TETs, early metabolic response closely correlates with outcome of therapy. [(18)F]-FDG PET may be used to monitor treatment efficacy and assess histologic differences in patients with advanced TETs.
authors: Medical Oncology Branch, National Cancer Institute, Bethesda, Maryland 20892, USA.
authors: Anish
authors: A
authors: Thomas
authors: Esther
authors: E
authors: Mena
authors: Karen
authors: K
authors: Kurdziel
authors: David
authors: D
authors: Venzon
authors: Sean
authors: S
authors: Khozin
authors: Arlene W
authors: AW
authors: Berman
authors: Peter
authors: P
authors: Choyke
authors: Eva
authors: E
authors: Szabo
authors: Arun
authors: A
authors: Rajan
authors: Giuseppe
authors: G
authors: Giaccone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003952:Diagnostic Imaging / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology
chemical_list: D019788:Fluorodeoxyglucose F18
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