Research ArticleClinical Investigation

18F-FDG PET/CT for the Prediction and Detection of Local Recurrence After Radiofrequency Ablation of Malignant Lung Lesions

Amit Singnurkar, Stephen B. Solomon, Mithat Gönen, Steven M. Larson and Heiko Schöder
Journal of Nuclear Medicine December 2010, 51 (12) 1833-1840; DOI: https://doi.org/10.2967/jnumed.110.076778

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Patterns of uptake on post-RFA 18F-FDG PET/CT images: diffuse (A), focal (B), rim (C), heterogeneous (D), rim plus focal with focus not corresponding to site of original lesion (E), and rim plus focal with focus corresponding to site of original lesion (F). Dotted circles represent location of original lesion.

  • FIGURE 2.
    FIGURE 2.

    Imaging follow-up of ablated lesions.

  • FIGURE 3.
    FIGURE 3.

    Kaplan–Meier curves for recurrence-free survival according to pretreatment lesion size (cm).

  • FIGURE 4.
    FIGURE 4.

    Follow-up after RFA for primary non–small cell lung adenocarcinoma. 18F-FDG PET/CT image at 4.5 mo after RFA (A) shows typical early pattern of ring of low-grade (SUV, 3.0) metabolic activity (arrow), and 18F-FDG PET/CT image at 9 mo after RFA (B) shows interval decrease in metabolic activity (arrow) (SUV, 0.8).

  • FIGURE 5.
    FIGURE 5.

    Local recurrence with rim plus focal uptake. CT image (A) shows left upper lobe pulmonary metastasis before RFA, and transaxial 18F-FDG PET image at 6 wk after RFA (B) shows rim plus focal uptake with focal uptake corresponding to site of original lesion (arrow). (C) No treatment was performed; PET/CT fusion image obtained 3 mo later shows interval progression (arrow). This lesion was then surgically resected and histopathology proved local recurrence.

  • FIGURE 6.
    FIGURE 6.

    Kaplan–Meier curves showing recurrence-free survival according to pattern of 18F-FDG uptake. F = favorable; U = unfavorable.

Tables

  • TABLE 1

    Local Recurrence According to Pathologic Subtype of Pulmonary Lesion

    PathologynRecurrenceNonrecurrence
    Primary pulmonary lesion442024
     Adenocarcinoma18810
     Squamous cell carcinoma1073
     Undifferentiated non–small cell carcinoma1046
     Adenosquamous carcinoma11—
     Bronchioalveolar carcinoma3—3
     Small cell carcinoma2—2
    Metastatic lesion38830
     Colorectal20119
     Sarcoma514
     Fibrosarcoma1—1
     Head and neck squamous cell carcinoma1—1
     Adrenal312
     Breast1—1
     Esophageal11—
     Insulinoma1—1
     Germ cell1—1
     Renal22—
     Adenocarcinoma, unknown primary11—
     Carcinoma, unknown primary11—
  • TABLE 2

    Local Recurrence According to Pattern of Uptake on Post-RFA Scan

    PatternRecurrenceNonrecurrence
    Favorable
     Diffuse510
     Heterogeneous01
     Rim36
     Rim plus focal, corresponding81
      Corresponding
    Unfavorable
     Focal21
     Rim plus focal, not corresponding12
      Corresponding
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