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Purpose: Previous research showed that pretreatment uptake of F-18 fluorodeoxyglucose (FDG), as assessed by the maximal standardized uptake value (SUVmax) and the variability of uptake (FDGhetero), predicted for posttreatment response in cervical cancer. In this pilot study, we evaluated the changes in SUVmax and FDGhetero during concurrent chemoradiation for cervical cancer and their association with post-treatment response.

Methods and Materials: Twenty-five patients with stage Ib1-IVa cervical cancer were enrolled. SUVmax, FDGhetero, and metabolic tumor volume (MTV) were recorded from FDG-positron emission tomography (PET)/computed tomography (CT) scans performed pretreatment and during weeks 2 and 4 of treatment and were evaluated for changes and association with response assessed on 3-month post-treatment FDG-PET/CT.

Results: For all patients, the average pretreatment SUVmax was 17.8, MTV was 55.4 cm3, and FDGhetero was -1.33. A similar decline in SUVmax was seen at week 2 compared with baseline and week 4 compared with week 2 (34%). The areas of highest FDG uptake in the tumor remained relatively consistent on serial scans. Mean FDGhetero decreased during treatment. For all patients, MTV decreased more from week 2 to week 4 than from pretreatment to week 2. By week 4, the average SUVmax had decreased by 57% and the MTV had decreased by 30%. Five patients showed persistent or new disease on 3-month post-treatment PET. These poor responders showed a higher average SUVmax, larger MTV, and greater heterogeneity at all 3 times. Week 4 SUVmax (P=.037), week 4 FDGhetero (P=.005), pretreatment MTV (P=.008), and pretreatment FDGhetero (P=.008) were all significantly associated with post-treatment PET response.

Conclusions: SUVmax shows a consistent rate of decline during treatment and declines at a faster rate than MTV regresses. Based on this pilot study, pretreatment and week 4 of treatment represent the best time points for prediction of response.

Titel:	Changes in cervical cancer FDG uptake during chemoradiation and association with response.
Autor/in / Beteiligte Person:	Kidd, EA ; Thomas, M ; Siegel, BA ; Dehdashti, F ; Grigsby, PW
Zeitschrift:	International journal of radiation oncology, biology, physics, Jg. 85 (2013), Heft 1, S. 116-22
Veröffentlichung:	New York, NY : Elsevier, Inc ; <i>Original Publication</i>: Elmsford, N. Y., Pergamon Press., 2013
Medientyp:	academicJournal
ISSN:	1879-355X (electronic)
DOI:	10.1016/j.ijrobp.2012.02.056
Schlagwort:	Adenocarcinoma diagnostic imaging Adenocarcinoma metabolism Adenocarcinoma pathology Adenocarcinoma therapy Adult Aged Aged, 80 and over Antineoplastic Agents therapeutic use Brachytherapy methods Carcinoma, Squamous Cell diagnostic imaging Carcinoma, Squamous Cell metabolism Carcinoma, Squamous Cell pathology Carcinoma, Squamous Cell therapy Cisplatin therapeutic use Female Humans Middle Aged Pilot Projects Prospective Studies Radiation-Sensitizing Agents therapeutic use Radiotherapy Dosage Remission Induction methods Uterine Cervical Neoplasms metabolism Uterine Cervical Neoplasms pathology Chemoradiotherapy methods Fluorodeoxyglucose F18 pharmacokinetics Multimodal Imaging methods Positron-Emission Tomography Radiopharmaceuticals pharmacokinetics Tomography, X-Ray Computed Tumor Burden Uterine Cervical Neoplasms diagnostic imaging Uterine Cervical Neoplasms therapy
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, N.I.H., Extramural Language: English [Int J Radiat Oncol Biol Phys] 2013 Jan 01; Vol. 85 (1), pp. 116-22. <i>Date of Electronic Publication: </i>2012 Apr 18. MeSH Terms: Positron-Emission Tomography* ; Tomography, X-Ray Computed* ; Tumor Burden* ; Chemoradiotherapy / methods ; Fluorodeoxyglucose F18 / pharmacokinetics ; Multimodal Imaging / methods ; Radiopharmaceuticals / pharmacokinetics ; Uterine Cervical Neoplasms / diagnostic imaging ; Uterine Cervical Neoplasms / therapy ; Adenocarcinoma / diagnostic imaging ; Adenocarcinoma / metabolism ; Adenocarcinoma / pathology ; Adenocarcinoma / therapy ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents / therapeutic use ; Brachytherapy / methods ; Carcinoma, Squamous Cell / diagnostic imaging ; Carcinoma, Squamous Cell / metabolism ; Carcinoma, Squamous Cell / pathology ; Carcinoma, Squamous Cell / therapy ; Cisplatin / therapeutic use ; Female ; Humans ; Middle Aged ; Pilot Projects ; Prospective Studies ; Radiation-Sensitizing Agents / therapeutic use ; Radiotherapy Dosage ; Remission Induction / methods ; Uterine Cervical Neoplasms / metabolism ; Uterine Cervical Neoplasms / pathology References: Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):392-9. (PMID: 19646825) ; Eur J Cancer. 1999 Dec;35(13):1773-82. (PMID: 10673991) ; Int J Radiat Oncol Biol Phys. 2002 Jun 1;53(2):353-9. (PMID: 12023139) ; Arch Neurol. 1989 Dec;46(12):1302-7. (PMID: 2556096) ; J Clin Oncol. 2004 Mar 1;22(5):900-8. (PMID: 14990646) ; Int J Radiat Oncol Biol Phys. 2012 May 1;83(1):185-90. (PMID: 22014958) ; Radiat Oncol. 2011 Jun 09;6:69. (PMID: 21658258) ; Int J Gynecol Cancer. 2009 Dec;19(9):1600-5. (PMID: 19955945) ; Eur J Cancer. 1995 Nov;31A(12):1924-7. (PMID: 8562143) ; Int J Radiat Oncol Biol Phys. 2008 Aug 1;71(5):1402-7. (PMID: 18234432) ; J Nucl Med. 1992 Nov;33(11):1981-7. (PMID: 1432159) ; Radiother Oncol. 2011 May;99(2):137-41. (PMID: 21571386) ; Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):177-81. (PMID: 16545921) ; Clin Cancer Res. 2008 Aug 15;14(16):5236-41. (PMID: 18698042) ; Radiother Oncol. 2007 Feb;82(2):145-52. (PMID: 17258339) ; J Clin Oncol. 2007 Jul 20;25(21):3116-23. (PMID: 17634490) ; JAMA. 2007 Nov 21;298(19):2289-95. (PMID: 18029833) ; Cancer. 2007 Oct 15;110(8):1738-44. (PMID: 17786947) ; Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1502-7. (PMID: 18538498) ; J Clin Oncol. 2004 Mar 1;22(5):872-80. (PMID: 14990643) Grant Information: P30 CA091842 United States CA NCI NIH HHS; R01 CA136931 United States CA NCI NIH HHS; R01 CA136931-01A2 United States CA NCI NIH HHS; RR00807 United States RR NCRR NIH HHS Substance Nomenclature: 0 (Antineoplastic Agents) ; 0 (Radiation-Sensitizing Agents) ; 0 (Radiopharmaceuticals) ; 0Z5B2CJX4D (Fluorodeoxyglucose F18) ; Q20Q21Q62J (Cisplatin) Entry Date(s): Date Created: 20120424 Date Completed: 20130219 Latest Revision: 20211021 Update Code: 20231215 PubMed Central ID: PMC3404156

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Changes in cervical cancer FDG uptake during chemoradiation and association with response.