Differentiation of tumor recurrence from radiation-induced pulmonary fibrosis after stereotactic ablative radiotherapy f
- PDF / 1,973,889 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 0 Downloads / 185 Views
ORIGINAL ARTICLE
Differentiation of tumor recurrence from radiation-induced pulmonary fibrosis after stereotactic ablative radiotherapy for lung cancer: characterization of 18F-FDG PET/CT findings Naomi Nakajima • Yoshifumi Sugawara • Masaaki Kataoka • Yasushi Hamamoto Takashi Ochi • Shinya Sakai • Tadaaki Takahashi • Makoto Kajihara • Norihiro Teramoto • Motohiro Yamashita • Teruhito Mochizuki
•
Received: 5 September 2012 / Accepted: 26 December 2012 / Published online: 9 January 2013 Ó The Japanese Society of Nuclear Medicine 2013
Abstract Objective Stereotactic ablative radiotherapy (SABR), also known as stereotactic body radiotherapy (SBRT), is now a standard treatment option for patients with stage I non-small cell lung cancer or oligometastatic lung tumor who are medically inoperable or medically operable but refuse surgery. When mass-like consolidation is observed on follow-up CT after SABR, it is sometimes difficult to differentiate tumor recurrence from SABR-induced pulmonary fibrosis. In this study, we evaluated the role of 18 F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) in
N. Nakajima (&) M. Kataoka Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minamiumemoto-machi, Matsuyama, Ehime 791-0280, Japan e-mail: [email protected]; [email protected] Y. Sugawara S. Sakai T. Takahashi M. Kajihara Department of Diagnostic Radiology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minamiumemoto-machi, Matsuyama, Ehime 791-0280, Japan Y. Hamamoto T. Ochi T. Mochizuki Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan N. Teramoto Department of Pathology, National Hospital Organization Shikoku Cancer Center, Kou-160, Minamiumemoto-machi, Matsuyama, Ehime 791-0280, Japan M. Yamashita Department of Surgery, National Hospital Organization Shikoku Cancer Center, Kou-160, Minamiumemoto-machi, Matsuyama, Ehime 791-0280, Japan
differentiating tumor recurrence from radiation fibrosis after SABR. Methods Between June 2006 and June 2009, 130 patients received SABR for stage I non-small cell lung cancer or metastatic lung cancer at our institution. Fifty-nine patients of them were imaged with FDG-PET/CT after SABR. There were a total of 137 FDG-PET/CT scans for retrospective analysis. The FDG uptake in the pulmonary region was assessed qualitatively using a 3-point scale (0, none or faint; 1, mild; or 2, moderate to intense), and the shape (mass-like or non mass-like) was evaluated. For semiquantitative analysis, the maximum standardized uptake value (SUVmax) was calculated. Results Sixteen of 59 patients had local failure. In recurrent tumor, the combination of intensity grade 2 and mass-like shape was most common (21/23; 91 %). By contrast, in cases of radiation fibrosis, the combination of intensity grade 0 or 1 and non mass-like shape was most common (48/59; 81 %). The SUVmax of tumor recurrence after 12 mon
Data Loading...
