TY - JOUR
T1 - Repeatability of 18F-FDG PET/CT in Advanced Non-Small Cell Lung Cancer
T2 - Prospective Assessment in 2 Multicenter Trials
AU - ACRIN 6678 Research team
AU - Weber, Wolfgang A
AU - Gatsonis, Constantine A
AU - Mozley, P David
AU - Hanna, Lucy G
AU - Shields, Anthony F
AU - Aberle, Denise R
AU - Govindan, Ramaswamy
AU - Torigian, Drew A
AU - Karp, Joel S
AU - Yu, Jian Q Michael
AU - Subramaniam, Rathan M
AU - Halvorsen, Robert A
AU - Siegel, Barry A
N1 - Publisher Copyright:
© 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - UNLABELLED: PET/CT with the glucose analog (18)F-FDG has several potential applications for monitoring tumor response to therapy in patients with non-small cell lung cancer (NSCLC). A prerequisite for many of these applications is detailed knowledge of the repeatability of quantitative parameters derived from (18)F-FDG PET/CT studies.METHODS: The repeatability of the (18)F-FDG signal was evaluated in 2 prospective multicenter trials. Patients with advanced NSCLC (tumor stage III-IV) underwent two (18)F-FDG PET/CT studies while not receiving therapy. Tumor (18)F-FDG uptake was quantified by measurement of the maximum standardized uptake value within a lesion (SUVmax) and the average SUV within a small volume of interest around the site of maximum uptake (SUVpeak). Analysis was performed for the lesion in the chest with the highest (18)F-FDG uptake and a size of at least 2 cm (target lesion) as well as for up to 6 additional lesions per patient. Repeatability was assessed by Bland-Altman plots and calculation of 95% repeatability coefficients (RCs) of the log-transformed SUV differences.RESULTS: Test-retest repeatability was assessed in 74 patients (34 from the ACRIN 6678 trial and 40 from the Merck MK-0646-008 trial). SUVpeak was 11.57 ± 7.89 g/mL for the ACRIN trial and 6.89 ± 3.02 for the Merck trial. The lower and upper RCs were -28% (95% confidence interval [CI], -35% to -23%) and +39% (95% CI, 31% to 54%) in the ACRIN trial, indicating that a decrease of SUVpeak by more than 28% or an increase by more than 39% has a probability of less than 2.5%. The corresponding RCs from the Merck trial were -35% (95% CI, -42% to -29%) and +53% (95% CI, 41% to 72%). Repeatability was similar for SUVmax of the target lesion, averaged SUVmax, and averaged SUVpeak of up to 6 lesions per patient.CONCLUSION: The variability of repeated measurements of tumor (18)F-FDG uptake in patients with NSCLC is somewhat larger than previously reported in smaller single-center studies but comparable to that of gastrointestinal malignancies in a previous multicenter trial. The variability of measurements supports the definitions of tumor response according to PET Response Criteria in Solid Tumors.
AB - UNLABELLED: PET/CT with the glucose analog (18)F-FDG has several potential applications for monitoring tumor response to therapy in patients with non-small cell lung cancer (NSCLC). A prerequisite for many of these applications is detailed knowledge of the repeatability of quantitative parameters derived from (18)F-FDG PET/CT studies.METHODS: The repeatability of the (18)F-FDG signal was evaluated in 2 prospective multicenter trials. Patients with advanced NSCLC (tumor stage III-IV) underwent two (18)F-FDG PET/CT studies while not receiving therapy. Tumor (18)F-FDG uptake was quantified by measurement of the maximum standardized uptake value within a lesion (SUVmax) and the average SUV within a small volume of interest around the site of maximum uptake (SUVpeak). Analysis was performed for the lesion in the chest with the highest (18)F-FDG uptake and a size of at least 2 cm (target lesion) as well as for up to 6 additional lesions per patient. Repeatability was assessed by Bland-Altman plots and calculation of 95% repeatability coefficients (RCs) of the log-transformed SUV differences.RESULTS: Test-retest repeatability was assessed in 74 patients (34 from the ACRIN 6678 trial and 40 from the Merck MK-0646-008 trial). SUVpeak was 11.57 ± 7.89 g/mL for the ACRIN trial and 6.89 ± 3.02 for the Merck trial. The lower and upper RCs were -28% (95% confidence interval [CI], -35% to -23%) and +39% (95% CI, 31% to 54%) in the ACRIN trial, indicating that a decrease of SUVpeak by more than 28% or an increase by more than 39% has a probability of less than 2.5%. The corresponding RCs from the Merck trial were -35% (95% CI, -42% to -29%) and +53% (95% CI, 41% to 72%). Repeatability was similar for SUVmax of the target lesion, averaged SUVmax, and averaged SUVpeak of up to 6 lesions per patient.CONCLUSION: The variability of repeated measurements of tumor (18)F-FDG uptake in patients with NSCLC is somewhat larger than previously reported in smaller single-center studies but comparable to that of gastrointestinal malignancies in a previous multicenter trial. The variability of measurements supports the definitions of tumor response according to PET Response Criteria in Solid Tumors.
KW - Aged
KW - Carcinoma, Non-Small-Cell Lung/diagnostic imaging
KW - Fluorodeoxyglucose F18
KW - Humans
KW - Image Processing, Computer-Assisted
KW - Lung Neoplasms/diagnostic imaging
KW - Middle Aged
KW - Multimodal Imaging/methods
KW - Positron-Emission Tomography/methods
KW - Prospective Studies
KW - Radiopharmaceuticals
KW - Reproducibility of Results
KW - Tomography, X-Ray Computed/methods
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=84938849601&partnerID=8YFLogxK
U2 - 10.2967/jnumed.114.147728
DO - 10.2967/jnumed.114.147728
M3 - Article
C2 - 25908829
SN - 0161-5505
VL - 56
SP - 1137
EP - 1143
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 8
ER -
