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Time Course of Early Response to Chemotherapy in Non–Small Cell Lung Cancer Patients with ¹⁸F-FDG PET/CT

¹ Departments of Medicine and Radiology, University of Tennessee, Knoxville, Tennessee; and ² Department of Applied Mathematics, University of Western Ontario, London, Ontario, Canada

View larger version (29K): [in this window] [in a new window]   FIGURE 1.  Timing of PET/CT examinations and medication administration.

View larger version (11K): [in this window] [in a new window]   FIGURE 2.  Illustrative examples of least-squares fit (dashed line) to experimental data (diamonds). (A) Slope of regression line is not significantly different from zero (P = 0.799). Patient (patient 6) survived only 8 wk after end of chemotherapy. (B) Slope of regression line is significantly different from zero (P < 0.001). Patient (patient 3) is still alive, 20 mo after end of study.

View larger version (11K): [in this window] [in a new window]   FIGURE 3.  Slopes of regression line through SUVs for lung, bone marrow, liver, and tumor. Each symbol represents slope of line of best fit through 6 data points for unaffected lung, liver, or tumor. Open circles represent slopes that were not significantly different from zero; asterisks represent slopes different from zero at least at 5% level. Note that significance depends on both magnitude of slope and spread of underlying data; thus, open circles and asterisks may overlap. NS = not significant.

View larger version (21K): [in this window] [in a new window]   FIGURE 4.  Kaplan–Meier survival plot. Metabolic responders were defined as those patients for whom the slope through tumor data points was negative and significantly different from zero; metabolic nonresponders were defined as those patients for whom the slope was either positive or not significantly different from zero. Tick marks represent censored events—that is, survival time of those patients who have not yet reached the endpoint defined as death.

View larger version (15K): [in this window] [in a new window]   FIGURE 5.  Mean SUVs ± SEM are plotted for responder (asterisks) and nonresponder (open circles) groups. D = day.

View larger version (9K): [in this window] [in a new window]   FIGURE 6.  Change in SUV between days 21 and 7 for all patients. Asterisks represent those who survived >6 mo; open circles represent those who survived <6 mo. Dashed line represents a change of –0.5 SUV.