Abstract
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Introduction: The objective of this study was to investigate the potential of PET imaging to monitor tumor metabolic changes post-lung ablation treatment and to determine a correlation between PET results and tumor recurrence. The study also aimed to identify markers that could be used to predict the success of such interventions.
Methods: In this IRB-approved retrospective study, we examined patients who underwent lung tumor ablation for neoplasms between January 2014 and January 2022. Patients were identified using the Hi-IQ database, and clinical data were obtained from medical records. The imaging data from institutional PACS was analyzed descriptively to evaluate the utility of FDG-PET/CT in monitoring course progression following ablation. An adaptive contrast-oriented thresholding algorithm was applied to calculate the uncorrected SUVmean, partial volume correction (PVC) SUVmean, and Total lesion glycolysis (TLG). An automatic adaptive thresholding method (ROVER, ABX GmbH) was used to determine the metabolically active volume(MAV) of lesions.
Results: A study reviewed 42 lung tumor patients aged 30-89, with a slight female majority. Metastatic tumors, mostly from colorectal cancer, were present in 23 patients, while the rest had primarily non-small cell lung cancer. After lung ablation, PET scans indicated a reduction in the SUV mean for 63% of the participants. According to PERCIST, 37.5% achieved complete response, 18.7% had partial response, 18.7% remained stable, and 25% showed disease progression. Post-treatment, 63% saw a decrease in Total Lesion Glycolysis (TLG), with an average drop from 48.1 to 40.5, while 37.5% experienced an increase in TLG, averaging a change of -7.6.
Conclusions: The study confirms that FDG PET/CT is effective in evaluating lung tumor shrinkage post-ablation, with many patients showing reduced SUV means. PERCIST criteria indicated successful responses in several cases, and TLG analysis revealed both decreases and mixed outcomes, highlighting PET/CT's role in guiding patient treatment strategies.
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