What 18 F-FDG PET response-assessment method best predicts survival after curative-intent chemoradiation in non–small cell lung cancer: EORTC, PERCIST, Peter Mac criteria, or Deauville criteria?

Guy Anne Turgeon, Amir Iravani, Tim Akhurst, Alexis Beaulieu, Jason W. Callahan, Mathias Bressel, Aidan J. Cole, Sarah J. Everitt, Shankar Siva, Rodney J. Hicks, David L. Ball, Michael P. Mac Manus

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

The optimal methodology for defining response with 18 F-FDG PET after curative-intent chemoradiation for non–small cell lung cancer (NSCLC) is unknown. We compared survival outcomes according to the criteria of the European Organization for Research and Treatment of Cancer (EORTC), PERCIST 1.0, the Peter Mac metabolic visual criteria, and the Deauville criteria, respectively. Methods: Three prospective trials of chemoradiation for NSCLC, involving baseline and posttreatment 18 F-FDG PET/CT imaging, were conducted between 2004 and 2016. Responses were categorized as complete metabolic response (CMR), partial metabolic response, stable metabolic disease, or progressive metabolic disease. Cox proportional-hazards models and log-rank tests assessed the impact of each response on overall survival (OS). Results: Eighty-seven patients underwent 18 F-FDG PET/CT before and after radical chemoradiation for NSCLC. Follow-up 18 F-FDG PET/CT scans were performed at a median of 89 d (interquartile range, 79–93 d) after radiotherapy. Median follow-up and OS after PET response imaging were 49 and 28 mo, respectively. Interobserver agreements for EORTC, PERCIST, Peter Mac, and Deauville had k values of 0.76, 0.76, 0.87, and 0.84, respectively. All 4 response criteria were significantly associated with OS. Peter Mac and Deauville showed better fit than EORTC and PERCIST and distinguished better between CMR and non-CMR. Conclusion: All 4 response criteria were highly predictive of OS, but visual criteria showed greater interobserver agreement and stronger discrimination between CMR and non-CMR, highlighting the importance of visual assessment to recognize radiation pneumonitis, changes in lung configuration, and patterns of response.

Original languageEnglish
Pages (from-to)328-334
Number of pages7
JournalJournal of Nuclear Medicine
Volume60
Issue number3
DOIs
StatePublished - Mar 1 2019

Keywords

  • Deauville criteria
  • EORTC
  • FDG PET/CT
  • NSCLC
  • PERCIST
  • Peter Mac

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