Faculty Collaboration Database

Radiofrequency ablation of medically inoperable stage IA non-small cell lung cancer: are early posttreatment PET findings predictive of treatment outcome? AJR Am J Roentgenol 2011 Aug;197(2):334-40

Date

07/26/2011

Pubmed ID

21785078

Pubmed Central ID

PMC4063295

DOI

10.2214/AJR.10.6108

Scopus ID

2-s2.0-79960701078 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

OBJECTIVE: The purpose of this study was to evaluate initial experience with (18)F-FDG PET/CT after pulmonary radiofrequency ablation of stage IA non-small cell lung cancer to determine whether treatment success or residual disease can be predicted with early postablation PET.

SUBJECTS AND METHODS: Thirty patients with medically inoperable stage IA non-small cell lung cancer (12 men, 18 women; median age, 76 years; range, 60-87 years) underwent outpatient CT-guided radiofrequency ablation over a 33-month period. Mean tumor size was 2.0 cm (range, 1.3-2.9 cm). PET/CT was performed within 60 days before radiofrequency ablation (RFA), within 4 days after RFA, and 6 months after RFA. Metabolic response was categorized as complete response or partial or no response at early post-RFA PET/CT and complete response, partial response, or progressive metabolic disease at 6-month post-RFA PET/CT and was compared with the 1-year clinical event rate (death, disease progression at contrast-enhanced CT, or repeat ablation).

RESULTS: Early PET/CT images, obtained within 4 days of RFA, were evaluable for 26 patients (23 at 6 months). Patients with a complete metabolic response at early PET/CT had a 1-year event rate of 43%, whereas those with partial or no response or disease progression had a 1-year event rate of 67% (p = 0.27). Patients with a complete metabolic response at 6-month PET/CT had a 1-year event rate of 0%. Those with a partial response and those with disease progression had an overall event rate of 75% (p = 0.001).

CONCLUSION: Early post-RFA PET/CT is not necessary and 6-month post-RFA PET/CT findings correlate better with clinical outcome at 1 year.

Author List

Yoo DC, Dupuy DE, Hillman SL, Fernando HC, Rilling WS, Shepard JA, Siegel BA

Author

William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Biopsy
Carcinoma, Non-Small-Cell Lung
Catheter Ablation
Contrast Media
Disease Progression
Female
Fluorodeoxyglucose F18
Humans
Lung Neoplasms
Male
Middle Aged
Neoplasm Staging
Positron-Emission Tomography
Predictive Value of Tests
Radiography
Radiopharmaceuticals
Treatment Outcome