Skip to main content

18F-FDG uptake on PET helps predict outcome and response after treatment in unresectable thymic epithelial tumors

Annals of Nuclear Medicine volume 25, pages 247–253 (2011)Cite this article

Abstract

Background

Positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (18F-FDG) has been studied in thymic epithelial tumors. We evaluated the usefulness of 18F-FDG PET for monitoring after treatment in unresectable thymic epithelial tumors.

Method

Twelve patients with unresectable/metastatic thymic epithelial tumors underwent PET study with 18F-FDG before and after chemotherapy or radiotherapy. Response and survival were analyzed according to the ratio of the peak standardized uptake value (SUV) of the tumor to the mean SUV of the mediastinum (T/M ratio).

Results

Partial response (PR) evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) was noted in 4 (33%) of 12 patients, and partial metabolic response (PMR) was observed in 6 (50%) of 12 patients. PR was observed in 4 of 6 patients with PMR. In 6 patients with any response, the T/M ratio at post-treatment was significantly lower than at baseline (p = 0.0017). In 6 patients with stable disease (SD), stable metabolic disease (SMD) was observed in 5 by use of 18F-FDG PET. No statistically significant difference of 18F-FDG uptake between at baseline and post-therapy was observed in 6 patients with SD (p = 0.4157) and SMD (p = 0.8419). Although the overall survival after treatment showed no statistically significant difference between PMR and SMD or progressive metabolic disease in the whole group of patients including thymoma, a statistically significant difference in the overall survival was observed between 5 patients with PMR and 5 patients with non-PMR (p = 0.0280).

Conclusion

Our preliminary study suggests that 18F-FDG PET is useful for monitoring response and outcome after treatment in unresectable thymic epithelial tumors.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Sasaki R, Komaki R, Macapinlac H, Erasmus J, Allen P, Forster K, et al. [18F] fluorodeoxyglucose uptake by positron emission tomography predicts outcome of non-small-cell lung cancer. J Clin Oncol. 2005;23:1136–43.

    PubMed  Article  CAS  Google Scholar 

  2. Vansteenkiste JF, Stroobants SG, Dupont PJ, De Leyn PR, Verbeken EK, Deneffe GJ, et al. Prognostic importance of the standardized uptake value on 18F-fluoro-2-deoxy-glucose-positron emission tomography in non-small cell lung cancer: an analysis of 125 cases. J Clin Oncol. 1999;17:3201–6.

    PubMed  CAS  Google Scholar 

  3. Berghmans T, Dusart M, Paesmans M, Hossein-Foucher C, Buvat I, Castaigne C, et al. Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European lung cancer working party for the IASLC Lung Cancer Staging Project. J Thorac Oncol. 2008;3:6–12.

    PubMed  Article  Google Scholar 

  4. Ceresoli G, Chiti A, Zucali PA, Rodari M, Lutman RF, Salamina S, et al. Early response evaluation in malignant pleural mesothelioma by positron emission tomography with [18F] fluorodeoxygluose. J Clin Oncol. 2006;24:4587–93.

    PubMed  Article  Google Scholar 

  5. Kaira K, Endo M, Abe M, Nakagawa K, Ohde Y, Okumura T, et al. Biologic correlation of 2-[18F]-fluoro-2-deoxy-d-glucose uptake on positron emission tomography in thymic epithelial tumors. J Clin Oncol. 2010;28:3746–53.

    PubMed  Article  CAS  Google Scholar 

  6. Masaoka A, Monden Y, Nakahara K, Tanioka T. Follow-up study of thymomas with special reference to their clinical stages. Cancer. 1981;48:2485–92.

    PubMed  Article  CAS  Google Scholar 

  7. Rosai J, Sobin LH. Histological typing of tumours of the thymus, International histological classification of tumours. 2nd ed. New York: Springer; 1999. p. 1–59.

  8. Travis WD, Brambillia E, Muller-Hermelink HK. WHO classification of tumors. Pathology and genetics of tumors of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004.

    Google Scholar 

  9. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst. 2000;92:205–16.

    PubMed  Article  CAS  Google Scholar 

  10. Kong FM, Frey KA, Quint LE, Ten Haken RK, Hayman JA, Kessler M, et al. A pilot study of [18F] fluorodeoxyglucose positron emission tomography scans during and after radiation-based therapy in patients with non-small-cell lung cancer. J Clin Oncol. 2007;25:3116–23.

    PubMed  Article  Google Scholar 

  11. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. Eur J Cancer. 1999;35:1773–82.

    PubMed  Article  CAS  Google Scholar 

  12. Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERSIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50(Suppl):122S–47S.

    PubMed  Article  CAS  Google Scholar 

  13. Endo M, Nakagawa K, Ohde Y, Okumura T, Kondo H, Igawa S, et al. Utility of 18FDG-PET for differentiating the grade of malignancy in thymic epithelial tumors. Lung Cancer. 2008;61:350–5.

    PubMed  Article  Google Scholar 

  14. de Geus-Oei LF, van der Heijden HF, Corstens FH, Oyen WJ. Predictive and prognostic value of FDG-PET in nonsmall-cell lung cancer. A systematic review. Cancer. 2007;110:1654–64.

    PubMed  Article  Google Scholar 

  15. Pöttgen C, Levegrün S, Theegarten D, Marnitz S, Grehl S, Pink R, et al. Value of 18F-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography in non-small-cell lung cancer for prediction of pathologic response and times to relapse after neoadjuvant chemoradiotherapy. Clin Cancer Res. 2006;12:97–106.

    PubMed  Article  Google Scholar 

  16. Cerfolio RJ, Bryant AS, Winokur TS, Ohja B, Bartolucci AA. Repeat FDG-PET after neoadjuvant therapy is a predictor of pathologic response in patients with non-small cell lung cancer. Ann Thorac Surg. 2004;78:1903–9.

    PubMed  Article  Google Scholar 

  17. Sung YM, Lee KS, Kim BT, Choi JY, Shim YM, Yi CA. 18F-FDG PET/CT of thymic epithelial tumors: usefulness of distinguishing and staging tumor subgroups. J Nucl Med. 2006;47:1628–34.

    PubMed  Google Scholar 

  18. El-Bawab H, Al-Sugair AA, Rafay M, Choi JY, Shim YM, Yi CA. Role of fluorine-18 fluorodeoxyglucose positron emission tomography in thymic pathology. Eur J Cardiothorac Surg. 2007;31:731–6.

    PubMed  Article  Google Scholar 

  19. Kumar A, Regmi SK, Dutta R, Kumar R, Gupta SD, Das P, et al. Characterization of thymic masses using 18FDG PET-CT. Ann Nucl Med. 2009;23:569–77.

    PubMed  Article  Google Scholar 

Download references

Conflict of interest

We, all authors, have no financial or personal relationships with other people or organizations that could inappropriately influence our work.

Author information

Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Kyoichi Kaira, Haruyasu Murakami, Satoru Miura, Rieko Kaira, Hiroaki Akamatsu, Madoka Kimura, Akira Ono, Asuka Tsuya, Yukiko Nakamura, Tateaki Naito, Toshiaki Takahashi & Nobuyuki Yamamoto

  2. Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Masahiro Endo

Authors
  1. Kyoichi Kaira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Haruyasu Murakami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Satoru Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rieko Kaira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiroaki Akamatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Madoka Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Akira Ono
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Asuka Tsuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yukiko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tateaki Naito
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Toshiaki Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Masahiro Endo
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Nobuyuki Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyoichi Kaira.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kaira, K., Murakami, H., Miura, S. et al. 18F-FDG uptake on PET helps predict outcome and response after treatment in unresectable thymic epithelial tumors. Ann Nucl Med 25, 247–253 (2011). https://doi.org/10.1007/s12149-010-0455-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-010-0455-x

Keywords

  • 18F-FDG PET
  • Thymic epithelial tumor
  • Monitoring
  • Therapy response
  • Metabolic response