PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment
Purpose Inflammatory FDG uptake in the lung (PET-pneumonitis) following curative-intent radiotherapy (RT)/chemo-RT (CRT) in non-small cell lung cancer (NSCLC) can pose a challenge in FDG-PET/CT response assessment. The aim of this study is to describe different patterns of PET-pneumonitis to guide t...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2019-08, Vol.46 (9), p.1869-1877 |
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| creator | Iravani, Amir Turgeon, Guy-Anne Akhurst, Tim Callahan, Jason W. Bressel, Mathias Everitt, Sarah J. Siva, Shankar Hofman, Michael S. Hicks, Rodney J. Ball, David L. Mac Manus, Michael P. |
| description | Purpose
Inflammatory FDG uptake in the lung (PET-pneumonitis) following curative-intent radiotherapy (RT)/chemo-RT (CRT) in non-small cell lung cancer (NSCLC) can pose a challenge in FDG-PET/CT response assessment. The aim of this study is to describe different patterns of PET-pneumonitis to guide the interpretation of FDG-PET/CT and investigate its association with tumor response and overall survival (OS).
Methods
Retrospective analysis was performed on 87 NSCLC patients in three prospective trials who were treated with radical RT (
n
= 7) or CRT (
n
= 80), with baseline and post-treatment FDG-PET/CT. Visual criteria were performed for post-treatment FDG-PET/CT response assessment. The grading of PET-pneumonitis was based on relative lung uptake intensity compared to organs of reference and classified as per Deauville score from grade 1–5. Distribution patterns of PET-pneumonitis were defined as follows: A) patchy/sub-pleural; B) diffuse (involving more than a segment); and C) peripheral (diffusely surrounding a photopenic region).
Results
Follow-up FDG-PET/CT scans were performed approximately 3 months (median, 89 days; interquartile range, 79–93) after RT. Overall, PET-pneumonitis was present in 62/87 (71%) of patients, with Deauville 2 or 3 in 12/62 (19%) and 4 or 5 in 50/62 (81%) of patients. The frequency of patterns A, B and C of PET-pneumonitis was 19/62 (31%), 20/62 (32%) and 23/62 (37%), respectively. No association was found between grade or pattern of PET-pneumonitis and overall response at follow-up PET/CT (
p
= 0.27 and
p
= 0.56, respectively). There was also no significant association between PET-pneumonitis and OS (hazard ratio [HR], 1.3; 95% confidence interval [CI], 0.6–2.5;
p
= 0.45). Early FDG-PET/CT response assessment, however, was prognostic for OS (HR, 1.7; 95% CI, 1.2–2.2;
p
|
| doi_str_mv | 10.1007/s00259-019-04388-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2257719598</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2257719598</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-f5c64ac120deee3cfdf4825795410989f73145a43797d5d740f74227ba93b26b3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhiMEoqXwBzggS1zKIa0dJ-uYWxX6Ja0AieUcOfZk6yqxg8cBlZ_ZX1SH3RaJAwd_zPidZ8Z6s-wtoyeMUnGKlBaVzClLq-R1nfNn2SFbpVDQWj5_ugt6kL1CvKWU1UUtX2YHnDFJmRCH2f3X801uIIKOYMjkYB69s9Ei6f0w-F_WbYmeg4r2J-TWRXCR6BsYfVDGpqx3xDrivMtxVMNANKRtmJcq5TQEcvz5W7NuPnwkAbTfOvt7IU4qRggOiXKGKERAXNLxBogdJ6UjSdwlmgIYq5fmRHV2sPGO-J5cfLrM09ynzSZRcfIOYU8Z03yvsxe9GhDe7M-j7PvF-aa5ytdfLq-bs3Wuuahi3ld6VSrNCmoAgOve9GVdVEJWJaOylr3grKxUyYUUpjKipL0oi0J0SvKuWHX8KDvecafgf8yAsR0tLv9XDvyMbZFggslK1kn6_h_prZ-DS9MlVXKOiRWtkqrYqXTwiAH6dgp2VOGuZbRdHG93jrfJ8faP4y1PRe_26LkbwTyVPFqcBHwnwPTkthD-9v4P9gFYUbmZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2238817605</pqid></control><display><type>article</type><title>PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment</title><source>SpringerLink Journals - AutoHoldings</source><creator>Iravani, Amir ; Turgeon, Guy-Anne ; Akhurst, Tim ; Callahan, Jason W. ; Bressel, Mathias ; Everitt, Sarah J. ; Siva, Shankar ; Hofman, Michael S. ; Hicks, Rodney J. ; Ball, David L. ; Mac Manus, Michael P.</creator><creatorcontrib>Iravani, Amir ; Turgeon, Guy-Anne ; Akhurst, Tim ; Callahan, Jason W. ; Bressel, Mathias ; Everitt, Sarah J. ; Siva, Shankar ; Hofman, Michael S. ; Hicks, Rodney J. ; Ball, David L. ; Mac Manus, Michael P.</creatorcontrib><description>Purpose
Inflammatory FDG uptake in the lung (PET-pneumonitis) following curative-intent radiotherapy (RT)/chemo-RT (CRT) in non-small cell lung cancer (NSCLC) can pose a challenge in FDG-PET/CT response assessment. The aim of this study is to describe different patterns of PET-pneumonitis to guide the interpretation of FDG-PET/CT and investigate its association with tumor response and overall survival (OS).
Methods
Retrospective analysis was performed on 87 NSCLC patients in three prospective trials who were treated with radical RT (
n
= 7) or CRT (
n
= 80), with baseline and post-treatment FDG-PET/CT. Visual criteria were performed for post-treatment FDG-PET/CT response assessment. The grading of PET-pneumonitis was based on relative lung uptake intensity compared to organs of reference and classified as per Deauville score from grade 1–5. Distribution patterns of PET-pneumonitis were defined as follows: A) patchy/sub-pleural; B) diffuse (involving more than a segment); and C) peripheral (diffusely surrounding a photopenic region).
Results
Follow-up FDG-PET/CT scans were performed approximately 3 months (median, 89 days; interquartile range, 79–93) after RT. Overall, PET-pneumonitis was present in 62/87 (71%) of patients, with Deauville 2 or 3 in 12/62 (19%) and 4 or 5 in 50/62 (81%) of patients. The frequency of patterns A, B and C of PET-pneumonitis was 19/62 (31%), 20/62 (32%) and 23/62 (37%), respectively. No association was found between grade or pattern of PET-pneumonitis and overall response at follow-up PET/CT (
p
= 0.27 and
p
= 0.56, respectively). There was also no significant association between PET-pneumonitis and OS (hazard ratio [HR], 1.3; 95% confidence interval [CI], 0.6–2.5;
p
= 0.45). Early FDG-PET/CT response assessment, however, was prognostic for OS (HR, 1.7; 95% CI, 1.2–2.2;
p
< 0.001).
Conclusion
PET-pneumonitis is common in early post-CRT/RT, but pattern recognition may assist in response assessment by FDG-PET/CT. While FDG-PET/CT is a powerful tool for response assessment and prognostication, PET-pneumonitis does not appear to confound early response assessment or to independently predict OS.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-019-04388-3</identifier><identifier>PMID: 31190177</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cardiology ; Chemoradiotherapy ; Clinical trials ; Computed tomography ; Confidence intervals ; Evaluation ; Imaging ; Impact prediction ; Inflammation ; Lung cancer ; Medicine ; Medicine & Public Health ; Non-small cell lung carcinoma ; Nuclear Medicine ; Oncology ; Oncology – Chest ; Organs ; Original Article ; Orthopedics ; Pattern recognition ; Pneumonitis ; Positron emission ; Positron emission tomography ; Quality ; Radiation therapy ; Radiology ; Tomography</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2019-08, Vol.46 (9), p.1869-1877</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>European Journal of Nuclear Medicine and Molecular Imaging is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-f5c64ac120deee3cfdf4825795410989f73145a43797d5d740f74227ba93b26b3</citedby><cites>FETCH-LOGICAL-c375t-f5c64ac120deee3cfdf4825795410989f73145a43797d5d740f74227ba93b26b3</cites><orcidid>0000-0002-1273-5835</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-019-04388-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-019-04388-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31190177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iravani, Amir</creatorcontrib><creatorcontrib>Turgeon, Guy-Anne</creatorcontrib><creatorcontrib>Akhurst, Tim</creatorcontrib><creatorcontrib>Callahan, Jason W.</creatorcontrib><creatorcontrib>Bressel, Mathias</creatorcontrib><creatorcontrib>Everitt, Sarah J.</creatorcontrib><creatorcontrib>Siva, Shankar</creatorcontrib><creatorcontrib>Hofman, Michael S.</creatorcontrib><creatorcontrib>Hicks, Rodney J.</creatorcontrib><creatorcontrib>Ball, David L.</creatorcontrib><creatorcontrib>Mac Manus, Michael P.</creatorcontrib><title>PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose
Inflammatory FDG uptake in the lung (PET-pneumonitis) following curative-intent radiotherapy (RT)/chemo-RT (CRT) in non-small cell lung cancer (NSCLC) can pose a challenge in FDG-PET/CT response assessment. The aim of this study is to describe different patterns of PET-pneumonitis to guide the interpretation of FDG-PET/CT and investigate its association with tumor response and overall survival (OS).
Methods
Retrospective analysis was performed on 87 NSCLC patients in three prospective trials who were treated with radical RT (
n
= 7) or CRT (
n
= 80), with baseline and post-treatment FDG-PET/CT. Visual criteria were performed for post-treatment FDG-PET/CT response assessment. The grading of PET-pneumonitis was based on relative lung uptake intensity compared to organs of reference and classified as per Deauville score from grade 1–5. Distribution patterns of PET-pneumonitis were defined as follows: A) patchy/sub-pleural; B) diffuse (involving more than a segment); and C) peripheral (diffusely surrounding a photopenic region).
Results
Follow-up FDG-PET/CT scans were performed approximately 3 months (median, 89 days; interquartile range, 79–93) after RT. Overall, PET-pneumonitis was present in 62/87 (71%) of patients, with Deauville 2 or 3 in 12/62 (19%) and 4 or 5 in 50/62 (81%) of patients. The frequency of patterns A, B and C of PET-pneumonitis was 19/62 (31%), 20/62 (32%) and 23/62 (37%), respectively. No association was found between grade or pattern of PET-pneumonitis and overall response at follow-up PET/CT (
p
= 0.27 and
p
= 0.56, respectively). There was also no significant association between PET-pneumonitis and OS (hazard ratio [HR], 1.3; 95% confidence interval [CI], 0.6–2.5;
p
= 0.45). Early FDG-PET/CT response assessment, however, was prognostic for OS (HR, 1.7; 95% CI, 1.2–2.2;
p
< 0.001).
Conclusion
PET-pneumonitis is common in early post-CRT/RT, but pattern recognition may assist in response assessment by FDG-PET/CT. While FDG-PET/CT is a powerful tool for response assessment and prognostication, PET-pneumonitis does not appear to confound early response assessment or to independently predict OS.</description><subject>Cardiology</subject><subject>Chemoradiotherapy</subject><subject>Clinical trials</subject><subject>Computed tomography</subject><subject>Confidence intervals</subject><subject>Evaluation</subject><subject>Imaging</subject><subject>Impact prediction</subject><subject>Inflammation</subject><subject>Lung cancer</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Non-small cell lung carcinoma</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Oncology – Chest</subject><subject>Organs</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Pattern recognition</subject><subject>Pneumonitis</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Quality</subject><subject>Radiation therapy</subject><subject>Radiology</subject><subject>Tomography</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1v1DAQhiMEoqXwBzggS1zKIa0dJ-uYWxX6Ja0AieUcOfZk6yqxg8cBlZ_ZX1SH3RaJAwd_zPidZ8Z6s-wtoyeMUnGKlBaVzClLq-R1nfNn2SFbpVDQWj5_ugt6kL1CvKWU1UUtX2YHnDFJmRCH2f3X801uIIKOYMjkYB69s9Ei6f0w-F_WbYmeg4r2J-TWRXCR6BsYfVDGpqx3xDrivMtxVMNANKRtmJcq5TQEcvz5W7NuPnwkAbTfOvt7IU4qRggOiXKGKERAXNLxBogdJ6UjSdwlmgIYq5fmRHV2sPGO-J5cfLrM09ynzSZRcfIOYU8Z03yvsxe9GhDe7M-j7PvF-aa5ytdfLq-bs3Wuuahi3ld6VSrNCmoAgOve9GVdVEJWJaOylr3grKxUyYUUpjKipL0oi0J0SvKuWHX8KDvecafgf8yAsR0tLv9XDvyMbZFggslK1kn6_h_prZ-DS9MlVXKOiRWtkqrYqXTwiAH6dgp2VOGuZbRdHG93jrfJ8faP4y1PRe_26LkbwTyVPFqcBHwnwPTkthD-9v4P9gFYUbmZ</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Iravani, Amir</creator><creator>Turgeon, Guy-Anne</creator><creator>Akhurst, Tim</creator><creator>Callahan, Jason W.</creator><creator>Bressel, Mathias</creator><creator>Everitt, Sarah J.</creator><creator>Siva, Shankar</creator><creator>Hofman, Michael S.</creator><creator>Hicks, Rodney J.</creator><creator>Ball, David L.</creator><creator>Mac Manus, Michael P.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1273-5835</orcidid></search><sort><creationdate>20190801</creationdate><title>PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment</title><author>Iravani, Amir ; Turgeon, Guy-Anne ; Akhurst, Tim ; Callahan, Jason W. ; Bressel, Mathias ; Everitt, Sarah J. ; Siva, Shankar ; Hofman, Michael S. ; Hicks, Rodney J. ; Ball, David L. ; Mac Manus, Michael P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-f5c64ac120deee3cfdf4825795410989f73145a43797d5d740f74227ba93b26b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Cardiology</topic><topic>Chemoradiotherapy</topic><topic>Clinical trials</topic><topic>Computed tomography</topic><topic>Confidence intervals</topic><topic>Evaluation</topic><topic>Imaging</topic><topic>Impact prediction</topic><topic>Inflammation</topic><topic>Lung cancer</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Non-small cell lung carcinoma</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Oncology – Chest</topic><topic>Organs</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Pattern recognition</topic><topic>Pneumonitis</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Quality</topic><topic>Radiation therapy</topic><topic>Radiology</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iravani, Amir</creatorcontrib><creatorcontrib>Turgeon, Guy-Anne</creatorcontrib><creatorcontrib>Akhurst, Tim</creatorcontrib><creatorcontrib>Callahan, Jason W.</creatorcontrib><creatorcontrib>Bressel, Mathias</creatorcontrib><creatorcontrib>Everitt, Sarah J.</creatorcontrib><creatorcontrib>Siva, Shankar</creatorcontrib><creatorcontrib>Hofman, Michael S.</creatorcontrib><creatorcontrib>Hicks, Rodney J.</creatorcontrib><creatorcontrib>Ball, David L.</creatorcontrib><creatorcontrib>Mac Manus, Michael P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iravani, Amir</au><au>Turgeon, Guy-Anne</au><au>Akhurst, Tim</au><au>Callahan, Jason W.</au><au>Bressel, Mathias</au><au>Everitt, Sarah J.</au><au>Siva, Shankar</au><au>Hofman, Michael S.</au><au>Hicks, Rodney J.</au><au>Ball, David L.</au><au>Mac Manus, Michael P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>46</volume><issue>9</issue><spage>1869</spage><epage>1877</epage><pages>1869-1877</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose
Inflammatory FDG uptake in the lung (PET-pneumonitis) following curative-intent radiotherapy (RT)/chemo-RT (CRT) in non-small cell lung cancer (NSCLC) can pose a challenge in FDG-PET/CT response assessment. The aim of this study is to describe different patterns of PET-pneumonitis to guide the interpretation of FDG-PET/CT and investigate its association with tumor response and overall survival (OS).
Methods
Retrospective analysis was performed on 87 NSCLC patients in three prospective trials who were treated with radical RT (
n
= 7) or CRT (
n
= 80), with baseline and post-treatment FDG-PET/CT. Visual criteria were performed for post-treatment FDG-PET/CT response assessment. The grading of PET-pneumonitis was based on relative lung uptake intensity compared to organs of reference and classified as per Deauville score from grade 1–5. Distribution patterns of PET-pneumonitis were defined as follows: A) patchy/sub-pleural; B) diffuse (involving more than a segment); and C) peripheral (diffusely surrounding a photopenic region).
Results
Follow-up FDG-PET/CT scans were performed approximately 3 months (median, 89 days; interquartile range, 79–93) after RT. Overall, PET-pneumonitis was present in 62/87 (71%) of patients, with Deauville 2 or 3 in 12/62 (19%) and 4 or 5 in 50/62 (81%) of patients. The frequency of patterns A, B and C of PET-pneumonitis was 19/62 (31%), 20/62 (32%) and 23/62 (37%), respectively. No association was found between grade or pattern of PET-pneumonitis and overall response at follow-up PET/CT (
p
= 0.27 and
p
= 0.56, respectively). There was also no significant association between PET-pneumonitis and OS (hazard ratio [HR], 1.3; 95% confidence interval [CI], 0.6–2.5;
p
= 0.45). Early FDG-PET/CT response assessment, however, was prognostic for OS (HR, 1.7; 95% CI, 1.2–2.2;
p
< 0.001).
Conclusion
PET-pneumonitis is common in early post-CRT/RT, but pattern recognition may assist in response assessment by FDG-PET/CT. While FDG-PET/CT is a powerful tool for response assessment and prognostication, PET-pneumonitis does not appear to confound early response assessment or to independently predict OS.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31190177</pmid><doi>10.1007/s00259-019-04388-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1273-5835</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1619-7070 |
| ispartof | European journal of nuclear medicine and molecular imaging, 2019-08, Vol.46 (9), p.1869-1877 |
| issn | 1619-7070 1619-7089 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2257719598 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Cardiology Chemoradiotherapy Clinical trials Computed tomography Confidence intervals Evaluation Imaging Impact prediction Inflammation Lung cancer Medicine Medicine & Public Health Non-small cell lung carcinoma Nuclear Medicine Oncology Oncology – Chest Organs Original Article Orthopedics Pattern recognition Pneumonitis Positron emission Positron emission tomography Quality Radiation therapy Radiology Tomography |
| title | PET-detected pneumonitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): recognizing patterns and assessing the impact on the predictive ability of FDG-PET/CT response assessment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-07T05%3A10%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=PET-detected%20pneumonitis%20following%20curative-intent%20chemoradiation%20in%20non-small%20cell%20lung%20cancer%20(NSCLC):%20recognizing%20patterns%20and%20assessing%20the%20impact%20on%20the%20predictive%20ability%20of%20FDG-PET/CT%20response%20assessment&rft.jtitle=European%20journal%20of%20nuclear%20medicine%20and%20molecular%20imaging&rft.au=Iravani,%20Amir&rft.date=2019-08-01&rft.volume=46&rft.issue=9&rft.spage=1869&rft.epage=1877&rft.pages=1869-1877&rft.issn=1619-7070&rft.eissn=1619-7089&rft_id=info:doi/10.1007/s00259-019-04388-3&rft_dat=%3Cproquest_cross%3E2257719598%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2238817605&rft_id=info:pmid/31190177&rfr_iscdi=true |