Non-small cell lung cancer treated with erlotinib

Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis

Gary J R Cook, Mary E. O'Brien, Muhammad Siddique, Sugama Chicklore, Hoi Y. Loi, Bhupinder Sharma, Ravi Punwani, Paul Bassett, Vicky Goh, Sue Chua

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Purpose: To determine if first-order and high-order textural features on fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) images of non-small cell lung cancer (NSCLC) (a) at baseline, (b) at 6 weeks, or (c) the percentage change between baseline and 6 weeks can predict response or survival in patients treated with erlotinib. Materials and Methods: Institutional review board approval was obtained for post hoc analysis of data from a prospective single-center study for which informed consent was obtained. The study included 47 patients with NSCLC who underwent 18F-FDG PET/computed tomography (CT) at baseline (n = 47) and 6 weeks (n = 40) after commencing treatment with erlotinib. First-order and high-order primary tumor texture features reflecting image heterogeneity, standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured for all 18F-FDG PET studies. Response to erlotinib was assessed by using the Response Evaluation Criteria in Solid Tumors (RECIST) on CT images obtained at 12 weeks (n = 32). Associations between PET parameters, overall survival (OS), and RECIST-based treatment response were tested by Cox and logistic regression analyses, respectively. Results: Median OS was 14.1 months. According to CT RECIST at 12 weeks, there were 21 nonresponders and 11 responders. Response to erlotinib was associated with reduced heterogeneity (first-order standard deviation, P = .01; entropy, P = .001; uniformity, P = .001). At multivariable analysis, high-order contrast at 6 weeks (P = .002) and percentage change in first-order entropy (P = .03) were independently associated with survival. Percentage change in first-order entropy was also independently associated with treatment response (P = .01). Conclusion: Response to erlotinib is associated with reduced heterogeneity at 18F-FDG PET. Changes in first-order entropy are independently associated with OS and treatment response.

Original languageEnglish
Pages (from-to)883-893
Number of pages11
JournalRadiology
Volume276
Issue number3
DOIs
Publication statusPublished - 1 Sep 2015
Externally publishedYes

Fingerprint

Fluorodeoxyglucose F18
Non-Small Cell Lung Carcinoma
Positron-Emission Tomography
Entropy
Survival
Tomography
Therapeutics
Research Ethics Committees
Glycolysis
Tumor Burden
Informed Consent
Logistic Models
Regression Analysis
Erlotinib Hydrochloride
Response Evaluation Criteria in Solid Tumors
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cook, G. J. R., O'Brien, M. E., Siddique, M., Chicklore, S., Loi, H. Y., Sharma, B., ... Chua, S. (2015). Non-small cell lung cancer treated with erlotinib: Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis. Radiology, 276(3), 883-893. https://doi.org/10.1148/radiol.2015141309

Non-small cell lung cancer treated with erlotinib : Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis. / Cook, Gary J R; O'Brien, Mary E.; Siddique, Muhammad; Chicklore, Sugama; Loi, Hoi Y.; Sharma, Bhupinder; Punwani, Ravi; Bassett, Paul; Goh, Vicky; Chua, Sue.

In: Radiology, Vol. 276, No. 3, 01.09.2015, p. 883-893.

Research output: Contribution to journalArticle

Cook, GJR, O'Brien, ME, Siddique, M, Chicklore, S, Loi, HY, Sharma, B, Punwani, R, Bassett, P, Goh, V & Chua, S 2015, 'Non-small cell lung cancer treated with erlotinib: Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis', Radiology, vol. 276, no. 3, pp. 883-893. https://doi.org/10.1148/radiol.2015141309
Cook, Gary J R ; O'Brien, Mary E. ; Siddique, Muhammad ; Chicklore, Sugama ; Loi, Hoi Y. ; Sharma, Bhupinder ; Punwani, Ravi ; Bassett, Paul ; Goh, Vicky ; Chua, Sue. / Non-small cell lung cancer treated with erlotinib : Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis. In: Radiology. 2015 ; Vol. 276, No. 3. pp. 883-893.
@article{1ccd59377da8446faeab9ccae3d72410,
title = "Non-small cell lung cancer treated with erlotinib: Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis",
abstract = "Purpose: To determine if first-order and high-order textural features on fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) images of non-small cell lung cancer (NSCLC) (a) at baseline, (b) at 6 weeks, or (c) the percentage change between baseline and 6 weeks can predict response or survival in patients treated with erlotinib. Materials and Methods: Institutional review board approval was obtained for post hoc analysis of data from a prospective single-center study for which informed consent was obtained. The study included 47 patients with NSCLC who underwent 18F-FDG PET/computed tomography (CT) at baseline (n = 47) and 6 weeks (n = 40) after commencing treatment with erlotinib. First-order and high-order primary tumor texture features reflecting image heterogeneity, standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured for all 18F-FDG PET studies. Response to erlotinib was assessed by using the Response Evaluation Criteria in Solid Tumors (RECIST) on CT images obtained at 12 weeks (n = 32). Associations between PET parameters, overall survival (OS), and RECIST-based treatment response were tested by Cox and logistic regression analyses, respectively. Results: Median OS was 14.1 months. According to CT RECIST at 12 weeks, there were 21 nonresponders and 11 responders. Response to erlotinib was associated with reduced heterogeneity (first-order standard deviation, P = .01; entropy, P = .001; uniformity, P = .001). At multivariable analysis, high-order contrast at 6 weeks (P = .002) and percentage change in first-order entropy (P = .03) were independently associated with survival. Percentage change in first-order entropy was also independently associated with treatment response (P = .01). Conclusion: Response to erlotinib is associated with reduced heterogeneity at 18F-FDG PET. Changes in first-order entropy are independently associated with OS and treatment response.",
author = "Cook, {Gary J R} and O'Brien, {Mary E.} and Muhammad Siddique and Sugama Chicklore and Loi, {Hoi Y.} and Bhupinder Sharma and Ravi Punwani and Paul Bassett and Vicky Goh and Sue Chua",
year = "2015",
month = "9",
day = "1",
doi = "10.1148/radiol.2015141309",
language = "English",
volume = "276",
pages = "883--893",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Non-small cell lung cancer treated with erlotinib

T2 - Heterogeneity of 18F-FDG uptake at PET-association with treatment response and prognosis

AU - Cook, Gary J R

AU - O'Brien, Mary E.

AU - Siddique, Muhammad

AU - Chicklore, Sugama

AU - Loi, Hoi Y.

AU - Sharma, Bhupinder

AU - Punwani, Ravi

AU - Bassett, Paul

AU - Goh, Vicky

AU - Chua, Sue

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Purpose: To determine if first-order and high-order textural features on fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) images of non-small cell lung cancer (NSCLC) (a) at baseline, (b) at 6 weeks, or (c) the percentage change between baseline and 6 weeks can predict response or survival in patients treated with erlotinib. Materials and Methods: Institutional review board approval was obtained for post hoc analysis of data from a prospective single-center study for which informed consent was obtained. The study included 47 patients with NSCLC who underwent 18F-FDG PET/computed tomography (CT) at baseline (n = 47) and 6 weeks (n = 40) after commencing treatment with erlotinib. First-order and high-order primary tumor texture features reflecting image heterogeneity, standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured for all 18F-FDG PET studies. Response to erlotinib was assessed by using the Response Evaluation Criteria in Solid Tumors (RECIST) on CT images obtained at 12 weeks (n = 32). Associations between PET parameters, overall survival (OS), and RECIST-based treatment response were tested by Cox and logistic regression analyses, respectively. Results: Median OS was 14.1 months. According to CT RECIST at 12 weeks, there were 21 nonresponders and 11 responders. Response to erlotinib was associated with reduced heterogeneity (first-order standard deviation, P = .01; entropy, P = .001; uniformity, P = .001). At multivariable analysis, high-order contrast at 6 weeks (P = .002) and percentage change in first-order entropy (P = .03) were independently associated with survival. Percentage change in first-order entropy was also independently associated with treatment response (P = .01). Conclusion: Response to erlotinib is associated with reduced heterogeneity at 18F-FDG PET. Changes in first-order entropy are independently associated with OS and treatment response.

AB - Purpose: To determine if first-order and high-order textural features on fluorine 18 (18F) fluorodeoxyglucose (FDG) positron emission tomography (PET) images of non-small cell lung cancer (NSCLC) (a) at baseline, (b) at 6 weeks, or (c) the percentage change between baseline and 6 weeks can predict response or survival in patients treated with erlotinib. Materials and Methods: Institutional review board approval was obtained for post hoc analysis of data from a prospective single-center study for which informed consent was obtained. The study included 47 patients with NSCLC who underwent 18F-FDG PET/computed tomography (CT) at baseline (n = 47) and 6 weeks (n = 40) after commencing treatment with erlotinib. First-order and high-order primary tumor texture features reflecting image heterogeneity, standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured for all 18F-FDG PET studies. Response to erlotinib was assessed by using the Response Evaluation Criteria in Solid Tumors (RECIST) on CT images obtained at 12 weeks (n = 32). Associations between PET parameters, overall survival (OS), and RECIST-based treatment response were tested by Cox and logistic regression analyses, respectively. Results: Median OS was 14.1 months. According to CT RECIST at 12 weeks, there were 21 nonresponders and 11 responders. Response to erlotinib was associated with reduced heterogeneity (first-order standard deviation, P = .01; entropy, P = .001; uniformity, P = .001). At multivariable analysis, high-order contrast at 6 weeks (P = .002) and percentage change in first-order entropy (P = .03) were independently associated with survival. Percentage change in first-order entropy was also independently associated with treatment response (P = .01). Conclusion: Response to erlotinib is associated with reduced heterogeneity at 18F-FDG PET. Changes in first-order entropy are independently associated with OS and treatment response.

UR - http://www.scopus.com/inward/record.url?scp=84940869624&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940869624&partnerID=8YFLogxK

U2 - 10.1148/radiol.2015141309

DO - 10.1148/radiol.2015141309

M3 - Article

VL - 276

SP - 883

EP - 893

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -