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Monitoring Cancer Treatment with PET/CT: Does It Make a Difference?

¹ Department of Molecular and Medical Pharmacology, University of California, Los Angeles, California; and ² Division of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Los Angeles, California

View larger version (44K): [in this window] [in a new window]   FIGURE 1.  18F-FDG PET/CT studies in patient with soft-tissue sarcoma of right thigh. Patient was treated with presurgical chemotherapy, and histopathologic analysis revealed 95% treatment-induced necrosis. This finding was reflected by marked decrease in tumor 18F-FDG uptake. Quantitatively, tumor SUV decreased from 10.0 to 1.0. In contrast, there was no major change in tumor size on CT (arrows).

View larger version (12K): [in this window] [in a new window]   FIGURE 2.  Proposed design of randomized trials evaluating impact of PET on disease management. Patients were randomized to either standard therapy (A) or PET-controlled therapy (B). For group B, treatment was changed on basis of tumor response after brief period of therapy. Metabolic responders (as determined by PET) continued to receive standard therapy, whereas treatment was changed for metabolic nonresponders. Effect of this change in therapy was evaluated by comparing survival, morbidity, and treatment-related costs in arms A and B.