(18)F-FDG PET/CT is an immediate imaging biomarker of treatment success after liver metastasis ablation Journal Article

Authors: Cornelis, F.; Sotirchos, V.; Violari, E.; Sofocleous, C. T.; Schoder, H.; Durack, J. C.; Siegelbaum, R. H.; Maybody, M.; Humm, J.; Solomon, S. B.
Article Title: (18)F-FDG PET/CT is an immediate imaging biomarker of treatment success after liver metastasis ablation
Abstract: The rationale of this study was to examine whether 18F-FDG PET/CT and contrast-enhanced CT performed immediately after percutaneous ablation of liver metastases are predictors of local treatment failure at 1 y. Methods: This Health Insurance Portability and Accountability Act-compliant, Institutional Review Board-approved retrospective study reviewed 25 PET/CT-guided thermal ablations performed from September 2011 to March 2013 on 21 patients (11 women and 10 men; mean age, 56.8 y; range, 35-79 y) for the treatment of liver metastases (colorectal, n = 23; breast, n = 1; and sarcoma, n = 1). One to 3 tumors (mean size, 2.3 cm; range, 0.7-4.6 cm; mean SUVmax, 22.7; range, 9.5-77.1) were ablated using radiofrequency (n = 16) or microwave (n = 9) energy in a single session. Immediate-postablation enhanced CT and PET/CT scans were qualitatively evaluated by 2 reviewers independently, and the results were compared with clinical and imaging outcome at 1 y. The PET/CT scans were also analyzed to determine tissue radioactivity concentration (TRC) from 3-dimensional regions of interest in the ablation zone, the margin, and the surrounding normal liver to calculate a TRC ratio, which was then compared with outcome at 1 y. Receiver operating characteristics (ROC) were used, and the maximal-accuracy threshold in predicting recurrence was calculated. Results: Eleven (44%) of the 25 tumors recurred within 1 y. Enhanced CT did not significantly correlate with recurrence (P = 0.288). Accuracy was 64% (16/25), and the area under the ROC curve was 0.601 (95% confidence interval [95% CI], 0.387-0.789). The accuracy of the qualitative analysis of 18F-FDG PET was 92% (23/25) (P < 0.001), and the area under the ROC curve was 0.929 (95% CI, 0.740-0.990). The mean TRC ratio was 40.6 in the recurrence group (SD, 9.2; range, 29.3-53.9) and 15.9 in the group without recurrence (SD, 7.3; range, 3-27.3). A TRC ratio of 28.3 predicted recurrence at 1 y with 100% accuracy (25/25) (P < 0.001), and the area under the ROC curve was 1 (95% CI, 0.863-1). Conclusion: Immediate PET/CT accurately predicts the success of liver metastasis ablation at 1 y and is superior to immediate enhanced CT. © Copyright 2016 SNMMI; all rights reserved.
Keywords: treatment failure; interventional radiology; pet/ct; thermal ablation; imaging biomarkers
Journal Title: Journal of Nuclear Medicine
Volume: 57
Issue: 7
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2016-07-01
Start Page: 1052
End Page: 1057
Language: English
DOI: 10.2967/jnumed.115.171926
PROVIDER: scopus
PUBMED: 26912433
PMCID: PMC5484796
Notes: Article -- Export Date: 2 August 2016 -- Source: Scopus
Citation Impact
MSK Authors
  1. Heiko Schoder
    333 Schoder
  2. Majid Maybody
    76 Maybody
  3. Stephen Solomon
    303 Solomon
  4. John Laurence Humm
    366 Humm
  5. Jeremy Charles Durack
    95 Durack