Repeatability of 18F-FDG PET/CT in Advanced Non-Small Cell Lung Cancer: Prospective Assessment in 2 Multicenter...

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• 18F-FDG PET/CT is crucial for monitoring non-small cell lung cancer (NSCLC) treatment response.
• Accurate assessment requires understanding the repeatability of quantitative PET/CT parameters.

Purpose of the Study:

• To evaluate the test-retest repeatability of quantitative (18)F-FDG uptake measurements in patients with advanced NSCLC.
• To establish repeatability coefficients for key parameters like SUVmax and SUVpeak.

Main Methods:

• Two prospective, multicenter trials involving patients with stage III-IV NSCLC.
• Two (18)F-FDG PET/CT scans were performed on each patient before therapy.
• Quantitative analysis included SUVmax and SUVpeak for target lesions and up to six additional lesions.

Main Results:

• Repeatability coefficients for SUVpeak varied: -28% to +39% (ACRIN trial) and -35% to +53% (Merck trial).
• Variability was comparable for SUVmax and averaged SUVpeak across multiple lesions.
• These results indicate a degree of measurement variability in repeated (18)F-FDG PET/CT scans for NSCLC.

Conclusions:

• The observed variability in (18)F-FDG uptake measurements is larger than in some prior single-center studies but aligns with multicenter findings for other malignancies.
• The established repeatability coefficients provide a basis for interpreting treatment response in NSCLC.
• These findings support the use of standardized criteria like PET Response Criteria in Solid Tumors for evaluating therapeutic efficacy.