title: Early detection of disease progression after palliative chemotherapy in NSCLC patients by (18)F-FDG-PET.
abstract: OBJECTIVE
  We investigated whether 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is capable of detecting renewed disease progression earlier than computed tomography (CT) in patients with inoperable non-small cell lung cancer (NSCLC) who have undergone chemotherapy as part of a palliative treatment plan.
  
  
  METHODS
  18 patients were studied retrospectively. Three FDG-PET/CT scans for initial and follow-up diagnostic purposes were evaluated. Palliative chemotherapy was administered between the first FDG-PET/CT scan (t0) and the second (t1), followed by a treatment-free interval between the second FDG-PET/CT scan (t1) and the third (t2). Maximum standardized uptake values (SUVmax) and largest diameters of lesions were determined for PET scans and the corresponding CTs. Lesion-based and patient-based assessments were performed, as were assessments according to RECIST/PERCIST.
  
  
  RESULTS
  82 lesions were identified in 18 patients. In interval t1-t2, the increase in diameter in the lesion-based evaluation was 5.0% (non-significant), while the patient-based evaluation showed a non-significant reduction of 2.8%. Considering PET, both the lesion-based and patient-based evaluations found a significant increase in SUVmax by a median of 30.4 % and 45.8 %, respectively. PERCIST criteria at time point t2 identified ten more patients with progression than did RECIST.
  
  
  CONCLUSIONS
  In patients with NSCLC, renewed progression during the treatment-free interval after palliative chemotherapy can be detected earlier with PET than with CT. Thus, FDG-PET appears to be a useful diagnostic imaging procedure regarding this aspect. Its clinical relevance should be investigated in further studies.
authors.forename: E
authors.initials: E
authors.lastname: Tauhardt
authors.forename: A
authors.initials: A
authors.lastname: Reissig
authors.forename: T
authors.initials: T
authors.lastname: Winkens
authors.affiliation: Martin Freesmeyer, M.D., Clinic of Nuclear Medicine, Jena University Hospital, Bachstraße 18, 07740 Jena, Germany, Tel. +49/(0)36 41/93 32 20, Fax +49/(0)36 41/93 32 44, E-mail: martin.freesmeyer@med.uni-jena.de.
authors.forename: M
authors.initials: M
authors.lastname: Freesmeyer
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D019788:Fluorodeoxyglucose F18; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control*; D010166:Palliative Care / Q000706:statistics & numerical data*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG-PET; NSCLC; PERCIST; disease progression; early detection; palliative chemotherapy