| 저자(한글) |
Grootjans, W.,Usmanij, E.A.,Oyen, W.J.G.,van der Heijden, E.H.F.M.,Visser, E.P.,Visvikis, D.,Hatt, M.,Bussink, J.,de Geus-Oei, L.F. |
| 초록 |
Background and purpose: This study evaluated the use of total lesion glycolysis (TLG) determined by different automatic segmentation algorithms, for early response monitoring in non-small cell lung cancer (NSCLC) patients during concomitant chemoradiotherapy. Materials and methods: Twenty-seven patients with locally advanced NSCLC treated with concomitant chemoradiotherapy underwent 18 F-fluorodeoxyglucose (FDG) PET/CT imaging before and in the second week of treatment. Segmentation of the primary tumours and lymph nodes was performed using fixed threshold segmentation at (i) 40% SUV max (T40), (ii) 50% SUV max (T50), (iii) relative-threshold-level (RTL), (iv) signal-to-background ratio (SBR), and (v) fuzzy locally adaptive Bayesian (FLAB) segmentation. Association of primary tumour TLG (TLG T ), lymph node TLG (TLG LN ), summed TLG (TLG S = TLG T +TLG LN ), and relative TLG decrease ( Delta;TLG) with overall-survival (OS) and progression-free survival (PFS) was determined using univariate Cox regression models. Results: Pretreatment TLG T was predictive for PFS and OS, irrespective of the segmentation method used. Inclusion of TLG LN improved disease and early response assessment, with pretreatment TLG S more strongly associated with PFS and OS than TLG T for all segmentation algorithms. This was also the case for Delta;TLG S , which was significantly associated with PFS and OS, with the exception of RTL and T40. Conclusions: Delta;TLG S was significantly associated with PFS and OS, except for RTL and T40. Inclusion of TLG LN improves early treatment response monitoring during concomitant chemoradiotherapy with FDG-PET. |
