One Versus Up‑to‑5 Lesion Measurements for Response Assessment by PERCIST in Patients with Lung Cancer
10.1007/s13139-021-00697-4
- Author:
Soo Jin KWON
1
;
Joo Hyun O
;
Ie Ryung YOO
Author Information
1. Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo‑daero, Seocho‑gu, Seoul 06591, Republic of Korea
- Publication Type:ORIGINAL ARTICLE
- From:Nuclear Medicine and Molecular Imaging
2021;55(3):123-129
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The optimal number of lesions to measure for response assessment from fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) is not validated for lung cancer. We compared 1 lesion and up-to-5 lesion measurements for response assessment in lung cancer per PET Response Criteria in Solid Tumors (PERCIST).
Methods:Patients with lung cancer with pre- and post-treatment PET/CT images were included. The standard uptake value corrected for lean body mass (SULpeak) of up-to-5 hottest target lesions was measured at each time point. The percent changes of SULpeak of the single hottest lesion and the sum of up-to-5 hottest lesions were computed. Pearson correlation coefficient evaluated the strength of association between the percent changes of SUL peak values from the 1 lesion and up-to-5 lesion analyses. Response categories were complete metabolic response (CMR) with no perceptible lesion; partial metabolic response (PMR), stable metabolic disease (SMD), or progressive metabolic disease (PMD) using the threshold of 30% and 0.8 unit change in SULpeak ; and unequivocal new lesion meant PMD. The concordance for response categorization was assessed by kappa statistics.
Results:A total of 40 patients (25 non-small cell lung cancer; 15 small cell lung cancer) were analyzed, all with 18F-FDGavid lung cancer. Average of 3 target lesions were measured for up-to-5 lesion analysis. Pearson’s r was 0.74 (P < 0.001) and increased to 0.96 (P < 0.001) when two outliers were excluded. Response categorization with 1 lesion and up-to-5 lesion analyses was concordant in 37 patients (92.5%, weighted kappa = 0.89).
Conclusion:Analyzing 1 lesion and up-to-5 lesions for response assessment by PERCIST showed high concordance in patients with lung cancer.
