Split-dose technique for FDG PET/CT-guided percutaneous ablation: A method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness Journal Article

   

Authors:	Ryan, E. R.; Sofocleous, C. T.; Schoder, H.; Carrasquillo, J. A.; Nehmeh, S.; Larson, S. M.; Thornton, R.; Siegelbaum, R. H.; Erinjeri, J. P.; Solomon, S. B.
Article Title:	Split-dose technique for FDG PET/CT-guided percutaneous ablation: A method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness
Abstract:	Purpose: To describe a split-dose technique for fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT)-guided ablation that permits both target localization and evaluation of treatment effectiveness. Materials and Methods: Institutional review board approved the study with a waiver of consent. From July to December 2011, 23 patients (13 women, 10 men; mean age, 59 years; range, 35-87 years) with 29 FDG-Avid tumors (median size, 1.4 cm; range, 0.6-4.4 cm) were targeted for ablation. The location of the lesion was the liver (n = 23), lung (n = 4), adrenal gland (n = 1), and thigh (n = 1). Radiofrequency ablation was performed in 17 lesions; microwave ablation, in six; irreversible electroporation, in five; and cryoablation, in one. The pathologic condition of the tumor was metastatic colorectal adenocarcinoma in 18 lesions, primary hepatocellular carcinoma in one lesion, and a variety of metastatic tumors in the remaining 10 lesions. A total of 4 mCi (148 MBq) of FDG was administered before the procedure for localization and imaging guidance. At completion of the ablation, an additional 8 mCi (296 MBq) of FDG was administered to assess ablation adequacy. Results of subsequent imaging follow-up were used to determine if postablation imaging after the second dose of FDG reliably helped predict complete tumor ablation. Descriptive statistics were used to summarize the results. Results: Twenty-eight of 29 (97%) ablated lesions showed no residual FDG activity after the second intraprocedural FDG dose. One patient with residual activity underwent immediate biopsy that revealed residual viable tumor and was immediately re-treated. Follow-up imaging at a median of 155 days (range, 92-257 days) after ablation showed local recurrences in two (7%) lesions that were originally negative at postablation PET. Conclusion: Split-dose FDG PET/CT may be a useful tool to provide both guidance and endpoint evaluation, allowing an opportunity for repeat intervention if necessary. Further work is necessary to validate these concepts. q RSNA, 2013.
Journal Title:	Radiology
Volume:	268
Issue:	1
ISSN:	0033-8419
Publisher:	Radiological Society of North America, Inc.
Date Published:	2013-06-01
Start Page:	288
End Page:	295
Language:	English
DOI:	10.1148/radiol.13121462
PROVIDER:	scopus
PMCID:	PMC3689447
PUBMED:	23564714
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84879915060&partnerID=40&md5=f5029a60c61738f491ff5e7a10d458d0
Notes:	--- - "Export Date: 1 August 2013" - "CODEN: RADLA" - "Source: Scopus"

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