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

E. Aarntzen, L. Heijmen and W. Oyen




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 F-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 F-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 F-FDG PET/CT findings of disease activity are mandatory to develop uniform and quantitative criteria for PET evaluation. Moreover, the optimal timing of F-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.