18 F-FDG PET/CT in Local Ablative Therapies: A Systematic Review

J Nucl Med. 2018 Apr;59(4):551-556. doi: 10.2967/jnumed.117.198184. Epub 2018 Jan 18.

Abstract

Driven by the continuous improvement in the accuracy of cross-sectional imaging, image-guided minimally invasive local ablative therapies have received incremental interest over the past few years. In this article, we systematically review the currently available literature on 18F-FDG PET/CT to monitor the efficacy of these local ablative therapies. By including all local ablative treatment modalities, tumor types, and organ sites, we provide a comprehensive overview of the current status, identify general patterns across studies, and provide recommendations for future studies and clinical practice. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria were used to assess the quality of the reported diagnostic accuracy of the retrieved studies. Data in the literature suggest that 18F-FDG PET/CT is a highly accurate tool to assess the technical success of local treatment, to identify residual or recurrent tumor early after intervention, and to provide prognostic and predictive information. However, prospective interventional studies based on 18F-FDG PET/CT findings of disease activity are mandatory to develop uniform and quantitative criteria for PET evaluation. Moreover, the optimal timing of 18F-FDG PET/CT after treatment may vary according to the location of the disease, with very early imaging being possible in solid organs such as the liver but posttreatment imaging being challenging for 3 mo in a location such as the lung parenchyma.

Keywords: 18F-FDG PET/CT; local ablative therapy; radioembolization; radiofrequency ablation; response monitoring.

Publication types

  • Systematic Review

MeSH terms

  • Ablation Techniques*
  • Fluorodeoxyglucose F18*
  • Humans
  • Neoplasms / diagnostic imaging
  • Neoplasms / therapy
  • Positron Emission Tomography Computed Tomography / methods*
  • Treatment Outcome

Substances

  • Fluorodeoxyglucose F18