Evaluation of therapeutic response with 18-FDG PET-CT for non-small cell lung cancer case report and literature review

ABSTRACT

Positron Emission Tomography / Computed Tomography (PET-CT) is increasingly being used as to complement conventional imaging methods and improve the management of patients with non-small cells lung cancer (NSCLC). The objective of this work is to report on a case in which PET-CT was used as a complementary method to evaluate the therapeutic response in a patient with NSCLC, and to carry out a literature review of the theme. Female patient, 65 years-old, with NSCLC, stage IIIA (T2N2M0), was submitted to exclusive neoadjuvant chemotherapy and presented good response to the treatment, classified by the morphological criteria of the RECIST (Response Evaluation Criteria in Solid Tumors) as a partial response (reduction equal to or greater than 30 percent in the sum of the widest diameter of all the target lesions in the computed tomography). The metabolic evaluation by PET-CT showed a complete response (reduction equal to or higher than 80 percent at maximum SUV of the lesions), which was confirmed in the histopathological analysis of the surgical samples. In the case presented, and through the literature review, we show that the evaluation of response with metabolic criteria, associated with morphological criteria, may be more accurate than the use of morphological criteria alone.