PET in the management of locally advanced and metastatic NSCLC.
Despite considerable improvements in the treatment options for advanced-stage non-small-cell lung cancer (NSCLC), disease-specific survival remains poor. With the aim of improving patient outcome, the treatment paradigm of locally advanced NSCLC has shifted from solely radiotherapy towards combined and intensified treatment approaches. Also, treatment for patients with stage IV (oligo)metastatic NSCLC has evolved rapidly, with therapeutic options that include a number of targeted agents, surgery, and stereotactic ablative radiotherapy. However, personalizing treatment to the individual patient remains difficult and requires monitoring of biological parameters responsible for treatment resistance to facilitate treatment selection, guidance, and adaptation. PET is a well-established molecular imaging platform that enables non-invasive quantification of many biological parameters that are relevant to both local and systemic therapy. With increasing clinical evidence, PET has gradually evolved from a purely diagnostic tool to a multifunctional imaging modality that can be utilized for treatment selection, adaptation, early response monitoring, and follow up in patients with NSCLC. Herein, we provide a comprehensive overview of the available clinical data on the use of this modality in this setting, and discuss future perspectives of PET imaging for the clinical management of patients with locally advanced and metastatic NSCLC.
Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
Willem
W
Grootjans
Department of Radiology and Nuclear Medicine, Leiden University Medical Centre, P.O. Box 9600, 2300 RC, Leiden, Netherlands.
Lioe-Fee
LF
de Geus-Oei
Department of Radiation Oncology (MAASTRO) GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, Netherlands.
Esther G C
EG
Troost
Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
Eric P
EP
Visser
Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
Wim J G
WJ
Oyen
Department of Radiation Oncology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands.
Johan
J
Bussink
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary / Q000628:therapy; D019468:Disease Management; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D018802:Patient-Centered Care / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods