Review article

European Journal of Nuclear Medicine

, Volume 27, Issue 6, pp 731-743

First online:

Monitoring response to therapy in cancer using [18F]-2-fluoro-2-deoxy-d-glucose and positron emission tomography: an overview of different analytical methods

  • C. J. HoekstraAffiliated withClinical PET Centre, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • , I. PaglianitiAffiliated withDepartment of Nuclear Medicine, University Hospital of Florence, Florence, Italy
  • , O. S. HoekstraAffiliated withClinical PET Centre, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • , E. F. SmitAffiliated withDepartment of Pulmonary Medicine, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • , P. E. PostmusAffiliated withDepartment of Pulmonary Medicine, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • , G. J. J. TeuleAffiliated withClinical PET Centre, University Hospital Vrije Universiteit, Amsterdam, The Netherlands
  • , A. A. LammertsmaAffiliated withClinical PET Centre, University Hospital Vrije Universiteit, Amsterdam, The Netherlands

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Abstract.

[18F]-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) is considered a valuable tool in the diagnosis and staging of cancer. In addition, it seems promising as a technique to monitor response to therapy. Progress is hampered, however, by the fact that various methods for the analysis of uptake of FDG in tumours have been described and that it is by no means clear whether these methods have the same sensitivity for monitoring response to treatment. As interest in monitoring response using FDG PET is growing, the danger exists that non-optimal methods will be used for evaluation. Hence an overview of the various analytical methods is given, highlighting both advantages and shortcomings of each of the methods. The ideal analytical method for response monitoring should represent an optimal trade-off between accuracy and simplicity (clinical applicability). At present, that trade-off still needs to be defined. Studies relating response, as measured with any of the available analytical methods, to outcome are urgently needed. Until then response monitoring studies should be conducted in such a way that all analytical methods can be compared with the most quantitative one, which at present is full compartmental modelling of the data.

Key words: [18F]-2-fluoro-2-deoxy-d-glucose Positron emission tomography Cancer Response monitoring