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Correlation of Iodine Quantification and FDG Uptake in Early Therapy Response Assessment of Non-small Cell Lung Cancer: Possible Benefit of Dual-energy CT Scan as an Integral Part of PET/CT Examination

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Aim: To compare iodine-related and fluorine-18 fluorodeoxyglucose (18F-FDG) parameters during staging of lung cancer as well as during early follow-up, while investigating potential use and possible substitutability in the assessment… Click to show full abstract

Aim: To compare iodine-related and fluorine-18 fluorodeoxyglucose (18F-FDG) parameters during staging of lung cancer as well as during early follow-up, while investigating potential use and possible substitutability in the assessment of therapeutic response or prediction. Patients and Methods: Patients (n=45) with confirmed lung cancer underwent 18F-FDG positron-emission tomography (PET) using single-source dual-energy computed tomography was performed for staging and early follow-up. Correlation of FDG uptake and iodine-related parameters was assessed and comparison with therapy response was performed. Results: A strong correlation was found between the volumetric FDG parameters metabolic tumour volume (MTV) and total lesion glycolysis (TLG) and iodine uptake (IU) in staging (IU vs. MTV: rs=0.894; p<0.001 and IU vs. TLG: rs=0.874; p<0.001) and follow-up (IU vs. MTV: rs=0.934, p<0.001 and IU vs. TLG: rs=0.935, p<0.001). We also found significant correlation of change in these values between timepoints. We observed a significant correlation of IU, MTV and TLG with early therapy response and IU was found as a possible strong predictor. Conclusion: Strong correlation of IU and volume-based FDG parameters was proved in staging, follow-up and change during therapy. Potential role of IU in prediction of early therapy-response was identified. Our study suggests a significant benefit of using the dual-energy computed tomography as a part of 18F-FDG PET/CT in patients with lung cancer.

Keywords: correlation; therapy response; response; lung cancer

Journal Title: AntiCancer Research
Year Published: 2020

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