(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
DOI/URL:
Notes: Article -- Export Date: 2 August 2016 -- Source: Scopus
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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