• J Thorac Oncol · Apr 2010

    Value of combined interpretation of computed tomography response and positron emission tomography response for prediction of prognosis after neoadjuvant chemotherapy in non-small cell lung cancer.

    • Ho Yun Lee, Hyun Ju Lee, Young Tae Kim, Chang Hyun Kang, Bo Gun Jang, Doo Hyun Chung, Jin Mo Goo, Chang Min Park, Chang Hyun Lee, and Keon Wook Kang.
    • Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, Republic of Korea.
    • J Thorac Oncol. 2010 Apr 1; 5 (4): 497-503.

    IntroductionThe purpose of this study was to assess the value of tumor response evaluation using combined interpretation of [18F] fluorodeoxyglucose positron emission tomography (PET) and computed tomography (CT) for the prediction of clinical outcome and pathologic response in patients with stage III non-small cell lung cancer who underwent neoadjuvant chemotherapy followed by surgery.MethodsThis study was approved by the Institutional Review Board with a waiver of informed consent. Forty-four consecutive patients (M:F = 32:12; mean age, 60.7 years) with locally advanced non-small cell lung cancer received neoadjuvant chemotherapy followed by curative surgery. Time to recurrence (TTR) was stratified by radiologic, metabolic, and radiologic-metabolic response using the Kaplan-Meier method. The accuracy of radiologic, metabolic, and radiologic-metabolic response criteria for the prediction of pathologic response was evaluated.ResultsRadiologic-metabolic responders had a longer TTR than nonresponders (mean TTR, 58.7 months versus 22.3 months, p = 0.001 with criteria of >or=30% reduction of size and >or=50% reduction of [maximum standardized uptake value] SUVmax and mean TTR, 49.4 months versus 23.5 months, p = 0.022 with criteria of >or=30% reduction of size and >or=25% reduction of SUVmax, respectively). The TTR of radiologic responders (criteria of >or=30% reduction of size) and metabolic responders (criteria of >or=25% reduction of SUVmax) was not different from the TTR of nonresponders (p > 0.05). The accuracy for the prediction of pathologic response was 70% in radiologic responders, 52 to 75% in metabolic responders, and 73 to 82% in radiologic-metabolic responders.ConclusionsTumor response evaluation using combined interpretation of [18F] fluorodeoxyglucose-PET and CT was more effective than single interpretation of CT response or PET response alone for the prediction of tumor recurrence and pathologic response.

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