F-FDG PET/CT Performed Immediately After Percutaneous Ablation to Evaluate Outcomes of the Procedure: Preliminary Results

Overview

Journal Radiol Bras

Specialty Radiology

Date 2019 Feb 27

PMID 30804612

Citations 4

Authors

Juliana Romanato

Marcos Roberto Menezes

Allan de Oliveira Santos

Regis Otaviano Franca Bezerra

Mariana Cunha Lopes Lima

Elba Etchebehere

Affiliations

Soon will be listed here.

Abstract

Objective: To determine whether F-fluorodeoxyglucose positron emission tomography/computed tomography performed immediately after percutaneous ablation ( F-FDG PET/CT) is useful in evaluating the outcomes of the procedure.

Materials And Methods: This was a retrospective study of 20 patients (13 males, 7 females; mean age, 65.8 ± 12.1 years) submitted to percutaneous ablation of metastases. All of the lesions treated had shown focal uptake on a F-FDG PET/CT scan obtained at baseline. The primary tumors were mainly colorectal cancer (in 45%) or lung cancer (in 40%). F-FDG PET/CT was performed to identify any residual viable tumor cells. The treatment was considered a success (no viable tumor cells present) if no uptake of F-FDG was noted on the F-FDG PET/CT scan.

Results: Twenty-six lesions were submitted to percutaneous ablation with either cryoablation (n = 7) or radiofrequency ablation (n = 19). The mean lesion diameter was 2.52 ± 1.49 cm. For the detection of viable tumor cells, F-FDG PET/CT had a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 66.7%, 95%, 88.5%, 80%, and 90.5%, respectively. There was a significant correlation between the F-FDG PET/CT findings and the results of the follow-up studies (kappa = 0.66; < 0.01).

Conclusion: F-FDG PET/CT studies appear to constitute a useful means of evaluating the outcomes of percutaneous ablation. By detecting residual viable tumor cells, this strategy might allow early re-intervention, thus reducing morbidity. Studies involving larger numbers of patients are needed in order to confirm our findings.

Citing Articles

Image guided ablation.

Zhang X, Melzer A Scott Med J. 2021; 66(4):175-177.

PMID: 34743636 PMC: 8573691. DOI: 10.1177/0036933020973637.

Use of PET/CT to aid clinical decision-making in cases of solitary pulmonary nodule: a probabilistic approach.

Mourato F, Brito A, Romao M, Santos R, de Almeida C, de Almeida Filho P Radiol Bras. 2020; 53(1):1-6.

PMID: 32313329 PMC: 7159041. DOI: 10.1590/0100-3984.2019.0034.

Cryoablation of Lung Metastases: Review of Recent Literature and Ablation Technique.

Eiken P, Welch B Semin Intervent Radiol. 2019; 36(4):319-325.

PMID: 31680723 PMC: 6823100. DOI: 10.1055/s-0039-1697002.

Is F-FDG PET/CT a real breakthrough imaging test in predicting the outcome of percutaneous ablation of metastases?.

Buchpiguel C Radiol Bras. 2019; 52(2):V-VI.

PMID: 31019353 PMC: 6472853. DOI: 10.1590/0100-3984.2019.52.2e1.

References

McGhana J, Dodd 3rd G . Radiofrequency ablation of the liver: current status. AJR Am J Roentgenol. 2001; 176(1):3-16. DOI: 10.2214/ajr.176.1.1760003. View

Kaufman C, Bachman B, Littrup P, White M, Carolin K, Francescatti D . Office-based ultrasound-guided cryoablation of breast fibroadenomas. Am J Surg. 2002; 184(5):394-400. DOI: 10.1016/s0002-9610(02)01010-3. View

Donckier V, Van Laethem J, Goldman S, Van Gansbeke D, Feron P, Ickx B . [F-18] fluorodeoxyglucose positron emission tomography as a tool for early recognition of incomplete tumor destruction after radiofrequency ablation for liver metastases. J Surg Oncol. 2004; 84(4):215-23. DOI: 10.1002/jso.10314. View

Akeboshi M, Yamakado K, Nakatsuka A, Hataji O, Taguchi O, Takao M . Percutaneous radiofrequency ablation of lung neoplasms: initial therapeutic response. J Vasc Interv Radiol. 2004; 15(5):463-70. DOI: 10.1097/01.rvi.0000126812.12853.77. View

Antoch G, Saoudi N, Kuehl H, Dahmen G, Mueller S, Beyer T . Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol. 2004; 22(21):4357-68. DOI: 10.1200/JCO.2004.08.120. View

Barker D, Zagoria R, Morton K, Kavanagh P, Shen P . Evaluation of liver metastases after radiofrequency ablation: utility of 18F-FDG PET and PET/CT. AJR Am J Roentgenol. 2005; 184(4):1096-102. DOI: 10.2214/ajr.184.4.01841096. View

Veit P, Antoch G, Stergar H, Bockisch A, Forsting M, Kuehl H . Detection of residual tumor after radiofrequency ablation of liver metastasis with dual-modality PET/CT: initial results. Eur Radiol. 2005; 16(1):80-7. DOI: 10.1007/s00330-005-2767-0. View

Gandhi N, Dupuy D . Image-guided radiofrequency ablation as a new treatment option for patients with lung cancer. Semin Roentgenol. 2005; 40(2):171-81. DOI: 10.1053/j.ro.2005.01.009. View

Nguyen C, Scott W, Young N, Rader T, Giles L, Goldberg M . Radiofrequency ablation of primary lung cancer: results from an ablate and resect pilot study. Chest. 2005; 128(5):3507-11. DOI: 10.1378/chest.128.5.3507. View

10.

Kuehl H, Antoch G . How much CT do we need for PEt/CT? A radiologist's perspective. Nuklearmedizin. 2006; 44 Suppl 1:S24-31. View

11.

Erturk S, Ichikawa T, Fujii H, Yasuda S, Ros P . PET imaging for evaluation of metastatic colorectal cancer of the liver. Eur J Radiol. 2006; 58(2):229-35. DOI: 10.1016/j.ejrad.2005.11.042. View

12.

Davol P, Fulmer B, Rukstalis D . Long-term results of cryoablation for renal cancer and complex renal masses. Urology. 2006; 68(1 Suppl):2-6. DOI: 10.1016/j.urology.2006.03.066. View

13.

Okuma T, Matsuoka T, Okamura T, Wada Y, Yamamoto A, Oyama Y . 18F-FDG small-animal PET for monitoring the therapeutic effect of CT-guided radiofrequency ablation on implanted VX2 lung tumors in rabbits. J Nucl Med. 2006; 47(8):1351-8. View

14.

Specht L . 2-[18F]fluoro-2-deoxyglucose positron-emission tomography in staging, response evaluation, and treatment planning of lymphomas. Semin Radiat Oncol. 2007; 17(3):190-7. DOI: 10.1016/j.semradonc.2007.02.005. View

15.

Khandani A, Calvo B, ONeil B, Jorgenson J, Mauro M . A pilot study of early 18F-FDG PET to evaluate the effectiveness of radiofrequency ablation of liver metastases. AJR Am J Roentgenol. 2007; 189(5):1199-202. DOI: 10.2214/AJR.07.2126. View

16.

Orlacchio A, Bazzocchi G, Pastorelli D, Bolacchi F, Angelico M, Almerighi C . Percutaneous cryoablation of small hepatocellular carcinoma with US guidance and CT monitoring: initial experience. Cardiovasc Intervent Radiol. 2008; 31(3):587-94. DOI: 10.1007/s00270-008-9293-9. View

17.

Witzsch U, Skriapas K, Becht E . [Cryoablation of prostate cancer]. Urologe A. 2008; 47(4):449-54. DOI: 10.1007/s00120-008-1660-2. View

18.

Poeppel T, Krause B, Heusner T, Boy C, Bockisch A, Antoch G . PET/CT for the staging and follow-up of patients with malignancies. Eur J Radiol. 2009; 70(3):382-92. DOI: 10.1016/j.ejrad.2009.03.051. View

19.

Masala S, Schillaci O, Bartolucci A, Calabria F, Mammucari M, Simonetti G . Metabolic and clinical assessment of efficacy of cryoablation therapy on skeletal masses by 18F-FDG positron emission tomography/computed tomography (PET/CT) and visual analogue scale (VAS): initial experience. Skeletal Radiol. 2010; 40(2):159-65. DOI: 10.1007/s00256-010-0960-y. View

20.

Liu Z, Chang Z, Lu Z, Guo Q . Early PET/CT after radiofrequency ablation in colorectal cancer liver metastases: is it useful?. Chin Med J (Engl). 2010; 123(13):1690-4. View