Serial 4DCT/4DPET imaging to predict and monitor response for locally-advanced non-small cell lung cancer chemo-radiotherapy. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Bissonnette, Jean-Pierre; Yap, Mei Ling; Clarke, Katy; Shessel, Andrea; Higgins, Jane; Vines, Douglass; Atenafu, Eshetu G.; Becker, Nathan; Leavens, Claudia; Bezjak, Andrea; Jaffray, David A.; Sun, Alexander
• Is Part Of: Radiotherapy and oncology. Volume 126:Issue 2(2018)
• Page Start: 347
• Page End: 354
• Publication Date: 2018-02
• Subjects: 4DCT -- 4DPET -- LA-NSCLC -- Response monitoring; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.11.023
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Background and purpose: A FDG-PET/CT image feature with optimal prognostic potential for locally-advanced non-small cell lung cancer (LA-NSCLC) patients has yet to be identified, and neither has the optimal time for FDG-PET/CT response assessment; furthermore, nodal features have been largely ignored in the literature. We propose to identify image features or imaging time point with maximal prognostic power. Materials and methods: Consecutive consenting patients with LA-NSCLC receiving curative intent CRT were enrolled. 4DPET/4DCT scans were acquired 0, 2, 4, and 7 weeks during IMRT treatment. Eleven image features and their rates of change were recorded for each time point and tested for each of the possible outcome 2 years post CRT using the Kaplan–Meier method. Results: 32 consecutive patients were recruited, 27 completing all scans. Restricting analysis to 4DPET/4DCT features and rates of change with p < 0.005, several volume-based features and their rates of change reached significance. Image features involving nodal disease were the only ones associated with overall survival. Conclusions: Several 4DPET/CT features and rates of change can reach significant association ( p < 0.005) with outcomes, including overall survival, at many time points. The optimal time for adaptive CRT is therefore not constrained uniquely on imaging.