Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Abstract

Abstract Background Lung cancer is the most common among all kinds of cancers. It still constitutes the leading cause of cancer-related deaths worldwide, even with major advancements in prevention and treatments available. More than 85% of the cases are of non-small cell lung cancer (NSCLC), while less than 15% are of small cell lung cancers (SCLCs). Patients and methods This is a prospective study of 20 patients confirmed histopathologically to have bronchogenic carcinoma, who came for assessment of therapeutic response. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after therapy. Semiquantitative assessment was used to determine maximum standardized uptake value (SUVmax). Treatment response evaluation was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results Comparison of the pre- and post-treatment SUVmax in the responder and non-responder groups revealed that the post-treatment SUV was significantly lower than the baseline SUV in the responder group (P = 0.008). The responder post-treatment SUV and ∆ SUV were significantly lower than the non-responder values (P = 0.014 and 0.0004 respectively). The optimum threshold values of post-treatment SUV and ∆ SUV threshold defined by the receiver operating characteristic (ROC) curve analysis were ≤ 8 and ≤ −48.3 respectively. The sensitivity, specificity, PPV, NPV, and AUC of post-treatment SUV for predicting tumor response were 100%, 66.67%, 66.7%, 100%, and 0.833 respectively. The sensitivity, specificity, PPV, NPV, and AUC of ∆ SUV for predicting tumor response were 100%, 91.67%, 88.9%, 100%, and 0.979% respectively. Conclusion PET/CT proved itself as useful, efficient, and reliable tool in follow-up of lung cancer patients as it gives an early and accurate metabolic response assessment before any CT changes, leading to early modification of therapy or confirmation of its efficiency.