Impact of pretreatment whole-tumor perfusion computed tomography and 18F-fluorodeoxyglucose positron emission tomography/computed tomography measurements on local control of non-small cell lung cancer treated with stereotactic body radiotherapy.
This study aimed to investigate the correlation between the average iodine density (AID) detected by dual-energy computed tomography (DE-CT) and the maximum standardized uptake value (SUVmax) yielded by [18F] fluorodeoxyglucose positron emission tomography (18F-FDG PET) for non-small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). Seventy-four patients with medically inoperable NSCLC who underwent both DE-CT and18F-FDG PET/CT before SBRT (50‒60 Gy in 5‒6 fractions) were followed up after a median interval of 24.5 months. Kaplan-Meier analysis was used to determine associations between local control (LC) and variables, including AID, SUVmax, tumor size, histology, and prescribed dose. The median AID and SUVmaxwere 18.64 (range, 1.18-45.31) (100 µg/cm3) and 3.2 (range, 0.7-17.6), respectively. No correlation was observed between AID and SUVmaxTwo-year LC rates were 96.2% vs 75.0% (P = 0.039) and 72.0% vs 96.2% (P = 0.002) for patients classified according to high vs low AID or SUVmax, respectively. Two-year LC rates for patients with adenocarcinoma vs squamous cell carcinoma vs unknown cancer were 96.4% vs 67.1% vs 92.9% (P = 0.008), respectively. Multivariate analysis identified SUVmaxas a significant predictor of LC. The 2-year LC rate was only 48.5% in the subgroup of lower AID and higher SUVmaxvs >90% (range, 94.4-100%) in other subgroups (P = 0.000). Despite the short follow-up period, a reduction in AID and subsequent increase in SUVmaxcorrelated significantly with local failure in SBRT-treated NSCLC patients. Further studies involving larger populations and longer follow-up periods are needed to confirm these results.
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan maoki@hirosaki-u.ac.jp.
Masahiko
M
Aoki
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Hiroyoshi
H
Akimoto
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Mariko
M
Sato
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan Department of Radiation Oncology, Southern Tohoku BNCT Research Center, 7-10 Yatsuyamada, 963-8052 Koriyama, Fukushima, Japan.
Katsumi
K
Hirose
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Hideo
H
Kawaguchi
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Yoshiomi
Y
Hatayama
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Hiroko
H
Seino
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Shinya
S
Kakehata
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Fumiyasu
F
Tsushima
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Hiromasa
H
Fujita
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Tamaki
T
Fujita
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Ichitaro
I
Fujioka
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Mitsuki
M
Tanaka
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Hiroyuki
H
Miura
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Shuichi
S
Ono
Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, 036-8562 Hirosaki, Aomori, Japan.
Yoshihiro
Y
Takai
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010477:Perfusion; D000072078:Positron Emission Tomography Computed Tomography; D016634:Radiosurgery
D019788:Fluorodeoxyglucose F18
FDG-PET/CT; SUVmax
; average iodine density; dual-energy CT; non–small cell lung cancer; stereotactic body radiotherapy