Title | Split-dose technique for FDG PET/CT-guided percutaneous ablation: a method to facilitate lesion targeting and to provide immediate assessment of treatment effectiveness. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | E Ryan R, Sofocleous CT, Schöder H, Carrasquillo JA, Nehmeh S, Larson SM, Thornton R, Siegelbaum RH, Erinjeri JP, Solomon SB |
Journal | Radiology |
Volume | 268 |
Issue | 1 |
Pagination | 288-95 |
Date Published | 2013 Jul |
ISSN | 1527-1315 |
Keywords | Adult, Aged, Aged, 80 and over, Catheter Ablation, Female, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Multimodal Imaging, Neoplasms, Positron-Emission Tomography, Radiopharmaceuticals, Retrospective Studies, Tomography, X-Ray Computed |
Abstract | PURPOSE: To describe a split-dose technique for fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT)-guided ablation that permits both target localization and evaluation of treatment effectiveness. MATERIALS AND METHODS: Institutional review board approved the study with a waiver of consent. From July to December 2011, 23 patients (13 women, 10 men; mean age, 59 years; range, 35-87 years) with 29 FDG-avid tumors (median size, 1.4 cm; range, 0.6-4.4 cm) were targeted for ablation. The location of the lesion was the liver (n = 23), lung (n = 4), adrenal gland (n = 1), and thigh (n = 1). Radiofrequency ablation was performed in 17 lesions; microwave ablation, in six; irreversible electroporation, in five; and cryoablation, in one. The pathologic condition of the tumor was metastatic colorectal adenocarcinoma in 18 lesions, primary hepatocellular carcinoma in one lesion, and a variety of metastatic tumors in the remaining 10 lesions. A total of 4 mCi (148 MBq) of FDG was administered before the procedure for localization and imaging guidance. At completion of the ablation, an additional 8 mCi (296 MBq) of FDG was administered to assess ablation adequacy. Results of subsequent imaging follow-up were used to determine if postablation imaging after the second dose of FDG reliably helped predict complete tumor ablation. Descriptive statistics were used to summarize the results. RESULTS: Twenty-eight of 29 (97%) ablated lesions showed no residual FDG activity after the second intraprocedural FDG dose. One patient with residual activity underwent immediate biopsy that revealed residual viable tumor and was immediately re-treated. Follow-up imaging at a median of 155 days (range, 92-257 days) after ablation showed local recurrences in two (7%) lesions that were originally negative at postablation PET. CONCLUSION: Split-dose FDG PET/CT may be a useful tool to provide both guidance and endpoint evaluation, allowing an opportunity for repeat intervention if necessary. Further work is necessary to validate these concepts. |
DOI | 10.1148/radiol.13121462 |
Alternate Journal | Radiology |
PubMed ID | 23564714 |
PubMed Central ID | PMC3689447 |
Grant List | R21 CA131763 / CA / NCI NIH HHS / United States 5R21CA131763 / CA / NCI NIH HHS / United States |