Langer Natasha Hemicke, Langer Seppo W, Johannesen Helle Hjorth, Hansen Adam Espe, Costa Junia, Klausen Thomas Levin, Forman Julie, Olin Anders, Rasmussen Sine Hvid, Sørensen Jens Benn, Löfgren Johan, Kjær Andreas, Fischer Barbara Malene
Dept. of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Dept. of Oncology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Diagnostics (Basel). 2019 Mar 26;9(1):35. doi: 10.3390/diagnostics9010035.
With the increasing number of therapy options available for patients with lung cancer, early response evaluation is needed. We performed this pilot study to assess the feasibility of early, repeated Positron emission tomography-magnetic resonance (PET/MR), the impact of timing and the capability for response prediction in lung tumors during chemotherapy. Patients with stage IV non-small cell lung cancer referred for chemotherapy were prospectively recruited. Fluorine-18-Fluorodeoxyglucose(F-FDG)-PET/MR scans were performed prior to, during and after the first or second cycle of chemotherapy. Primary tumors were defined on all scans and size, FDG-uptake and apparent diffusion coefficient (ADC) were measured. Early response was described over time and a Standard Linear Mixed Model was applied to analyze changes over time. 45 FDG-PET/MR scans were performed in 11 patients. Whereas the overall changes measured by ADC did not change significantly, there was an overall significant decrease in FDG-uptake from pre to post treatment scans. There was no difference in the FDG-uptake measured 1 or 3 weeks after therapy, but uptake measured 2 weeks after therapy differed from measurements at week 3. Changes measured in patients scanned during the first treatment cycle appeared more pronounced than during the second cycle. This pilot study indicates that response evaluation shortly after initiation of chemotherapy appears concordant with later evaluation and probably more reliable than evaluation midway between cycles. Responses during or after the first cycle of chemotherapy rather than during subsequent cycles are likely to be more readily measured.
随着肺癌患者可用治疗方案数量的增加，需要进行早期反应评估。我们开展了这项初步研究，以评估早期、重复的正电子发射断层扫描-磁共振成像（PET/MR）的可行性、时间选择的影响以及化疗期间肺肿瘤反应预测的能力。前瞻性招募了接受化疗的IV期非小细胞肺癌患者。在化疗的第一个或第二个周期之前、期间和之后进行氟-18-氟脱氧葡萄糖（F-FDG）-PET/MR扫描。在所有扫描中确定原发性肿瘤，并测量其大小、FDG摄取和表观扩散系数（ADC）。随时间描述早期反应，并应用标准线性混合模型分析随时间的变化。对11名患者进行了45次FDG-PET/MR扫描。虽然通过ADC测量的总体变化没有显著改变，但从治疗前到治疗后的扫描中，FDG摄取总体上有显著下降。治疗后1周或3周测量的FDG摄取没有差异，但治疗后2周测量的摄取与第3周的测量结果不同。在第一个治疗周期期间扫描的患者中测量的变化比第二个周期期间更明显。这项初步研究表明，化疗开始后不久的反应评估似乎与后期评估一致，并且可能比周期中间的评估更可靠。化疗第一个周期期间或之后的反应可能比后续周期更容易测量。
