Atlas of Clinical PET-CT in Treatment Response Evaluation in Oncology

Contents
List of Contributors
Part I: Therapy Response Evaluation: Science and Practice
	1: Treatment Response Evaluation: Science and Practice
		1.1	 Introduction
		1.2	 Criteria for Evaluating Response
		1.3	 Traditional Response Criteria
		1.4	 Incorporation of Molecular Imaging into Response Criteria
		1.5	 Response Criteria and Immunotherapy
		1.6	 Practical Considerations
		References
	2: CT in Treatment Response Assessment in Oncology
		2.1	 Introduction
		2.2	 Current Response Assessment Criteria for Chemotherapy and Targeted Therapies
		2.3	 Pitfalls of RECIST 1.1
		2.4	 mRECIST in HCC
		2.5	 Lugano Classification in Lymphoma
		2.6	 Response Assessment Criteria in Immunotherapy
		2.7	 Conclusion
		References
	3: MRI and Diffusion-Weighted MRI in Treatment Response Evaluation Overview
		3.1	 Introduction
		3.2	 Response Evaluation by Tumour Burden or Anatomical Parameters
			3.2.1	 WHO and RECIST Criteria
			3.2.2	 iRECIST
			3.2.3	 Other Response Evaluation by Anatomical MRI in Specific Disease Contexts
				3.2.3.1	 Brain Tumour
				3.2.3.2	 Hepatocellular Carcinoma (HCC)
				3.2.3.3	 Rectal Cancer
		3.3	 Response Evaluation with Diffusion-Weighted Imaging (DWI)
		3.4	 Conclusion
		References
	4: PET and PET-CT in Treatment Response Evaluation: Overview
		4.1	 Introduction: Why Is Tumor Response Assessed by Imaging?
		4.2	 Assessment of Tumor Response: When and How?
			4.2.1	 Response Assessment by FDG PET
				4.2.1.1	 Response Assessment in Lymphoma
			4.2.2	 Response Assessment with Other PET Imaging Agents
			4.2.3	 Timing of Response Assessment
		4.3	 Responders vs. Nonresponders
		4.4	 Management and Type of Treatment
		4.5	 Common Patterns, Pitfalls, Variants, Advantages, and Limitations
			4.5.1	 Standardized Imaging Protocol
			4.5.2	 Impact of Therapy on FDG Metabolism
			4.5.3	 Radiation Therapy
			4.5.4	 Immunotherapy
			4.5.5	 Clinical Image Interpretation
		References
	5: Conventional Radiological Techniques and PET-CT in Treatment Response Evaluation in Postsurgical Setting
		5.1	 Introduction
		5.2	 Computed Tomography (CT)
		5.3	 Magnetic Resonance Imaging (MRI)
		5.4	 Positron Emission Tomography (PET)
		5.5	 Other Radiotracers (Neuroendocrine Tumors, Prostate Cancer)
		5.6	 Conclusion
		References
	6: Conventional Radiological and PET-CT Assessment of Treatment Response Evaluation in Chemotherapy Setting
		6.1	 Introduction
		6.2	 Conventional Radiological Techniques
		6.3	 PET/CT in Response Assessment to Chemotherapy
			6.3.1	 EORTC
			6.3.2	 IHP Criteria for Lymphoma
			6.3.3	 Deauville Criteria for Lymphoma
			6.3.4	 PERCIST
		6.4	 MRI and CT in Response Assessment to Chemotherapy
		6.5	 Evaluation of Response to Chemotherapy in Individual Tumours
			6.5.1	 Oesophageal and Gastric Cancer
			6.5.2	 Colorectal Cancer
			6.5.3	 Hepatocellular Carcinoma
			6.5.4	 Pancreatic Cancer
			6.5.5	 Lung Cancer
			6.5.6	 Lymphoma
			6.5.7	 Head and Neck Cancer
			6.5.8	 Breast Cancer
			6.5.9	 Other Tumours
		6.6	 Conclusion
		References
	7: Conventional Radiological Techniques and PET-CT in Treatment Response Evaluation in Post-Radiotherapy Setting
		7.1	 Introduction
		7.2	 Functional Imaging for Disease Response Assessment to Radiotherapy
			7.2.1	 Functional, Metabolic PET Imaging
				7.2.1.1	 Glucose Metabolism
				7.2.1.2	 Tumor Hypoxia
				7.2.1.3	 Tumor Cell Proliferation
				7.2.1.4	 Apoptosis
				7.2.1.5	 Amino Acid Transport and Protein Synthesis
				7.2.1.6	 Cell Membrane Synthesis
				7.2.1.7	 Epidermal Growth Factor Receptor Status
			7.2.2	 Functional MR Imaging Techniques
				7.2.2.1	 Dynamic Contrast-Enhanced MR Imaging
				7.2.2.2	 Diffusion-Weighted MR Imaging
				7.2.2.3	 BOLD Imaging
				7.2.2.4	 MR Spectroscopy
			7.2.3	 Functional Imaging with Perfusion CT
			7.2.4	 Emerging Integrated Hybrid Imaging Techniques
				7.2.4.1	 Integrated PET/CT Perfusion Imaging
				7.2.4.2	 Integrated PET-MR Imaging
		7.3	 Assessment of Treatment Response After Radiotherapy
			7.3.1	 Anatomic Response Criteria (WHO, RECIST)
				7.3.1.1	 WHO Criteria
				7.3.1.2	 RECIST v1.1
				7.3.1.3	 Limitations of Anatomic Response Criteria
			7.3.2	 Metabolic Response Criteria
				7.3.2.1	 Qualitative Assessment
				7.3.2.2	 Quantitative Assessment (PERCIST v1.0)
		7.4	 Current Uses of FDG PET/CT in Treatment Response Following Radiation Therapy
			7.4.1	 Head and Neck Cancer
			7.4.2	 Esophageal Carcinoma
			7.4.3	 Rectal Carcinoma
			7.4.4	 Brain Tumors
			7.4.5	 Cervical Carcinoma
			7.4.6	 Lung Carcinoma
			7.4.7	 Hepato-Pancreatico-Biliary Tumors, Particularly Pancreatic Carcinoma and Liver Metastases (Postselective Internal Radiotherapy Treatment)
		References
	8: Conventional Radiological Techniques and PET-CT in Treatment Response Evaluation in Immunotherapy Settings
		8.1	 Introduction
		8.2	 Management: Type of Treatments/Regimes
			8.2.1	 Melanoma
			8.2.2	 NSCLC
			8.2.3	 Other Solid Tumors
		8.3	 Pathophysiology
		8.4	 Assessment of Treatment Response
			8.4.1	 Anatomic Response Assessment
			8.4.2	 Metabolic Response Criteria
			8.4.3	 Responders Vs. Non-Responders
			8.4.4	 Pitfalls and beyond (Pseudo-, Hyper-Progression, irAEs, Brain Mets, Cost-Effectiveness)
		References
	9: Treatment Response Evaluation of Bone Metastases Using 18F-NaF
		9.1	 Introduction
		9.2	 Management and Types of Treatments
			9.2.1	 Baseline 18F-Fluoride PET/CT
				9.2.1.1	 Prostate Cancer
				9.2.1.2	 Breast Cancer
				9.2.1.3	 Lung Cancer
				9.2.1.4	 Thyroid Cancer
				9.2.1.5	 Renal Cell Cancer
		9.3	 Assessment of Treatment Response (Postsurgical, Post Chemotherapy, Post Radiotherapy, Neoadjuvant, and Immunotherapy Settings)
			9.3.1	 Interim 18F-Fluoride PET/CT
				9.3.1.1	 Prostate Cancer
				9.3.1.2	 Breast Cancer
			9.3.2	 Follow-Up 18F-Fluoride PET/CT
				9.3.2.1	 Prostate Cancer
				9.3.2.2	 Breast Cancer
				9.3.2.3	 Multiple Myeloma
				9.3.2.4	 Metastatic Primary Bone Tumors
			9.3.3	 Conclusions
		9.4	 Common Patterns, Pitfalls, Variants, Advantages, and Limitations
		References
	10: Reporting Post-Therapy Scans
		10.1	 Introduction
		10.2	 Patient Preparation
		10.3	 Clinical Details
		10.4	 Questions to Ask Patient
		10.5	 When to Scan
		10.6	 What to Look for in the Scans
		10.7	 How to Describe, Report Post-Therapy Finding Scores, Criteria, etc. (Post-Surgical, Post-Chemotherapy, Post-Radiotherapy, and Post-Immunotherapy Settings)
		10.8	 Common and Less Common Findings
		10.9	 How to Interpret the Findings: Dos and Don’ts
			10.9.1	 What to Do
			10.9.2	 What Not to Do
		10.10	 What to Advise the Referrers
		References
Part II: Therapy Response Evaluation: Clinical Atlas
	11: 18F-FDG PET/CT in Treatment Response Evaluation in Head and Neck Cancer
		11.1	 Case 1
		11.2	 Case 2
		11.3	 Case 3
		11.4	 Case 4
		11.5	 Case 5
		11.6	 Case 6
		11.7	 Case 7
		11.8	 Case 8
		11.9	 Case 9
		11.10	 Case 10
		11.11	 Case 11
		11.12	 Case 12
		11.13	 Case 13
		11.14	 Case 14
		11.15	 Case 15
		Suggested Reading
			Case 3
	12: PET/CT in Treatment Response Evaluation: Lung Cancer
		12.1	 Introduction
		References
	13: 18F-FDG PET/CT and Non 18F-FDG-PET/CT in Treatment Response Evaluation in Neuro-Oncology
		13.1	 Introduction
		13.2	 PET Tracers Used in Neuro-Oncology
		13.3	 Case 1
		13.4	 Case 2
		13.5	 Case 3
		13.6	 Case 4
		13.7	 Case 5
		13.8	 Case 6
		13.9	 Case 7
		13.10	 Case 8
		13.11	 Case 9
		13.12	 Case 10
		13.13	 Case 11
		13.14	 Case 12
		13.15	 Case 13
		13.16	 Case 14
		13.17	 Case 15
		References
	14: PET/CT in the Assessment of Treatment Response in Hepatobiliary, Gall Bladder and Pancreatic Malignancies
		14.1	 Introduction
		14.2	 Case 1
		14.3	 Case 2
		14.4	 Case 3
		14.5	 Case 4
		14.6	 Case 5
		14.7	 Case 6
		14.8	 Case 7
		14.9	 Case 8
		14.10	 Case 9
		14.11	 Case 10
		14.12	 Case 11
		14.13	 Case 12
		14.14	 Case 13
		14.15	 Case 14
		14.16	 Case 15
		14.17	 Case 16
		14.18	 Case 17
		14.19	 Case 18
		Suggested Reading
			Introduction
			Case 1
			Case 2
			Case 3
			Case 4
			Case 6
			Case 7
			Case 8
			Case 11
	15: 18F-FDG PET/CT in Treatment Response Evaluation: Gastroesophageal Cancer
		15.1	 Introduction
		15.2	 Case No. 1: Radiation-Induced Esophagitis
		15.3	 Case No. 2: Radiation-Induced Pneumonitis
		15.4	 Case No. 3: Post Transthoracic Esophagectomy (TTE) Appearance
		15.5	 Case No. 4: Aspiration Pneumonia
		15.6	 Case No. 5: Recurrent Aspiration Pneumonia
		15.7	 Case No. 6: Tracheoesophageal Fistula (TOF)
		15.8	 Case No. 7: Upper Esophageal Mass with Complete Response Post CTRT
		15.9	 Case No. 8: Post CTRT Complete Response with Inflammatory Changes in the Esophagus
		15.10	 Case No. 9: Complete Response on PET/CT with Microscopic Residual Disease on Histopathology
		15.11	 Case No. 10: Posttreatment Changes Vs. Residual Disease
		15.12	 Case No. 11: Partial Response to Treatment
		15.13	 Case No. 12: Stable Disease with Radiation-Induced Esophagitis
		15.14	 Case No. 13: GE Junction Mass with Partial Response
		15.15	 Case No. 14: Complete Response
		15.16	 Case No. 15: Coexisting Malignancy and Granulomatous Infection
		15.17	 Case No. 16: Esophageal Primary with Coexisting Tuberculous Infection in the Lungs
		15.18	 Case No. 17: GE Junction and Proximal Stomach Mass with Partial Response
		15.19	 Case No. 18: Complete Response in Esophageal Primary with Marrow Hyperstimulation Post Chemotherapy
		15.20	 Case No. 19: Progressive Disease
		15.21	 Case No. 20: Post TTE Recurrence
		15.22	 Case No. 21: Recurrent Disease Post CTRT
		15.23	 Case No. 22: Recurrence and Then Progressive Disease
		15.24	 Case No. 23: Post CTRT Recurrence
		15.25	 Case No. 24: Post TTE Metastatic Disease
		15.26	 Case No. 25: Adenocarcinoma Stomach with Complete Metabolic Response
		References
	16: PET-CT in Treatment Response Evaluation in Lymphoma
		16.1	 Introduction
		16.2	 Case 1 (Fig. 16.4)
		16.3	 Case 2 (Fig. 16.5)
		16.4	 Case 3 (Fig. 16.6)
		16.5	 Case 4 (Fig. 16.7)
		16.6	 Case 5 (Fig. 16.8)
		16.7	 Case 6 (Fig. 16.9)
		16.8	 Case 7 (Fig. 16.10)
		16.9	 Case 8 (Fig. 16.11)
		Suggested Reading
			Introduction
			Case 1
	17: 18F-FDG PET/CT in Treatment Response Evaluation: Breast Cancer
		17.1	 Introduction
		17.2	 Clinical Examples
			17.2.1	 Case 1: Staging of Locally Advanced Breast Cancer
			17.2.2	 Case 2: Staging Metastatic Breast Cancer
			17.2.3	 Case 3: Coexistence of Infiltration and Inflammation/Infection Disease
			17.2.4	 Case 4: Prediction of Response to Treatment
			17.2.5	 Case 5: Monitoring Response to Treatment in Bone Metastatic Disease
			17.2.6	 Case 6: Progression and Potential Pitfalls
			17.2.7	 Case 7: Early Metastatic Spread
			17.2.8	 Case 8: Atypical Relapse
			17.2.9	 Case 9: False-Negative Findings
			17.2.10 Case 10: False-Positive Case
		Suggested Reading
			Case 1
			Case 2
			Case 3
			Case 4
			Case 5
			Case 6
			Case 7
			Case 8
			Case 9
			Case 10
	18: 18F-Choline, 68Ga-PSMA-11 and 18F-FDG PET/CT in Treatment Response Evaluation: Prostate Cancer
		18.1	 Introduction
		18.2	 Case 1: 11C-Choline PET/CT: Biodistribution and Variants
		18.3	 Case 2: 11C-Choline PET/CT Pitfalls: Paget’s Disease
		18.4	 Case 3: 18F-Choline PET/CT: Biodistribution and Pitfalls
		18.5	 Case 4: 11C-Choline PET/CT: Staging
		18.6	 Case 5: 11C-Choline PET/CT: Mediastinal Lymph Nodes
		18.7	 Case 6: 11C-Choline PET/CT: Biochemical Recurrence
		18.8	 Case 7: 18F-Choline PET/CT: Biochemical Recurrence
		18.9	 Case 8: 18F-Choline PET/CT During Androgen Deprivation Therapy (ADT)
		18.10	 Case 9: 11C-Choline PET/CT: Oligometastatic Patient
		18.11	 Case 10: 11C-Choline PET/CT: Metastatic Castration-Resistant Prostate Cancer (mCRPC)
		18.12	 Case 11: 68Ga-PSMA-11: Biodistribution and Variants
		18.13	 Case 12: 68Ga-PSMA-11 PET/CT Pitfalls: Ganglia
		18.14	 Case 13: 68Ga-PSMA-11 PET/CT Pitfall: Paget’s Disease
		18.15	 Case 14: 68Ga-PSMA-11 PET/CT: Staging
		18.16	 Case 15: 68Ga-PSMA-11 PET/CT in Biochemical Recurrence: Local Relapse
		18.17	 Case 16: 68Ga-PSMA-11 PET/CT in Biochemical Recurrence: Bone Metastasis
		18.18	 Case 17: 68Ga-PSMA-11 PET/CT in Biochemical Recurrence: Distant Lymph Nodes
		18.19	 Case 18: Biochemical Persistence After Radical Therapy: 11C-Choline vs. 68Ga-PSMA-11 PET/CT
		18.20	 Case 19: 68Ga-PSMA-11 PET/CT: mCRPC
		18.21	 Case 20: 18F-FDG PET/CT in PCa
		References
			Case 1
			Case 2
			Case 3
			Case 4
			Case 5
			Case 6
			Case 7
			Case 8
			Case 9
			Case 10
			Case 11
			Case 12
			Case 13
			Case 14
			Case 15
			Case 16
			Case 17
			Case 18
			Case 19
			Case 20
	19: FDG PET/CT in Treatment Response Evaluation of Gynecological Malignancies
		19.1	 Role of FDG PET/CT in Treatment Response Evaluation of Cervical Carcinoma
			19.1.1	 Introduction
			19.1.2	 Case 1: Metastatic Carcinoma Cervix with Near-Complete Metabolic Response in FDG PET/CT
			19.1.3	 Case 2: Vesicovaginal and Rectovaginal Fistulas Complicating Response Evaluation in a Treatment Completed Cervix Carcinoma
			19.1.4	 Case 3: FDG PET/CT Showing Complete Metabolic Response to EBRT and ICA in Carcinoma Cervix
			19.1.5	 Case 4: FDG PET/CT in Treatment Evaluation in Metastatic Carcinoma Cervix—End of Treatment Assessment
			19.1.6	 Case 5: FDG PET/CT Showing Complete Metabolic Response in an Advanced Metastatic Cervix Cancer After Prior Disease Progression
		19.2	 Role of FDG PET/CT in Treatment Response Evaluation of Endometrial Carcinoma
			19.2.1	 Introduction
			19.2.2	 Case 1: FDG PET/CT Showing Near-Complete Metabolic Response in Endometrial Adenocarcinoma Post Chemotherapy
		19.3	 FDG PET/CT in Treatment Response Evaluation of Fallopian Tube Carcinoma
			19.3.1	 Introduction
			19.3.2	 Case 1: FDG PET/CT Showing Disease Progression in a Treatment Completed Case of Bilateral Fallopian Tube Carcinoma
			19.3.3	 Case 2: FDG PET/CT Showing Disease Progression in Form of Hepatic and Serosal Metastases in a Treatment Completed Bilateral Fallopian Tube Carcinoma
		19.4	 FDG PET/CT in Treatment Response Evaluation of Vaginal Carcinoma
			19.4.1	 Introduction
			19.4.2	 Case 1: FDG PET/CT Showing Near-Complete Metabolic Response After Chemotherapy in Vaginal Carcinoma and predicts Long-Term Remission
		19.5	 Role of FDG PET/CT in Treatment Response Evaluation in Vulval Carcinoma
			19.5.1	 Introduction
			19.5.2	 Case 1: FDG PET/CT Showing Early Disease Progression Post Chemotherapy in Relapsed Case of Carcinoma Vulva
		19.6	 Role of FDG PET/CT in Treatment Response Evaluation of Ovarian Carcinoma
			19.6.1	 Introduction
			19.6.2	 Case 1: FDG PET/CT Showing Favorable Response to Second-Line Chemotherapy Regimen in a Case of Platinum-Resistant Metastatic Ovarian Carcinoma
			19.6.3	 Case 2: FDG PET/CT Showing Treatment Failure to Bevacizumab-Based Chemotherapy in Ovarian Carcinoma
		References
			Cervical Carcinoma
			Endometrial Carcinoma
			Fallopian Tube Carcinoma
			Vaginal Carcinoma
			Vulval Carcinoma
			Ovarian Carcinoma
	20: [18F]FDG PET/CT in Treatment Response Evaluation: Colorectal Cancer
		20.1	 Introduction
		20.2	 Clinical Case 1: Colorectal Liver Metastasis
		20.3	 Clinical Case 2: Colorectal Liver Metastasis
		20.4	 Clinical Case 3: Sequel to Case 2
		20.5	 Clinical Case 4: Response Monitoring of Liver Metastases
		20.6	 Clinical Case 5: Response Monitoring of Liver Metastases
		20.7	 Clinical Case 6: Response Monitoring of Liver and Other Metastases
		20.8	 Clinical Case 7: Response Monitoring of Liver Metastases
		20.9	 Clinical Case 8: Residual Disease After Liver Metastasectomy?
		20.10	 Clinical Case 9: Palliative Treatment of Liver Metastases of Rectal Cancer
		20.11	 Clinical Case 10: Recurrent Disease After Liver Microwave Ablation (MWA)
		20.12	 Clinical Case 11: Recurrent Disease After Liver RFA
		20.13	 Clinical Case 12: Recurrent Disease After Liver RFA
		20.14	 Clinical Case 13: Pulmonary Metastases
		20.15	 Clinical Case 14: Lymph Node Metastases
		20.16	 Clinical Case 15: Response Monitoring to Neoadjuvant Chemoradiotherapy
		20.17	 Clinical Case 16: Monitoring Response to Neoadjuvant Chemoradiotherapy
		20.18	 Clinical Case 17: Recurrent Colorectal Cancer
		20.19	 Clinical Case 18: Recurrent Colorectal Cancer
		20.20	 Clinical Case 19: Response Monitoring of Neoadjuvant Treatment of Local Recurrent Rectal Cancer
		20.21	 Clinical Case 20: Response Monitoring of Neoadjuvant Treatment of Local Recurrent Rectal Cancer
		References
	21: 18F-FDG PET in Treatment Response Evaluation: Soft Tissue Sarcomas
		21.1	 Introduction
		21.2	 Case 1: Progression
		21.3	 Case 2: Good Response to Treatment
		21.4	 Case 3: Disease Progression
		21.5	 Case 4: Mixed Response with Disease Progression
		21.6	 Case 5: Disease Progression
		21.7	 Case 6: Mixed Metabolic Response
		References
	22: 18F-FDG PET-CT in Treatment Response Evaluation in Cutaneous Malignant Melanoma
		22.1	 Introduction
		22.2	 Case 1
		22.3	 Case 2
		22.4	 Case 3
		22.5	 Case 4
		22.6	 Case 5
		22.7	 Case 6
		References
	23: 18F-FDG PET-CT in Treatment Response Evaluation: Multiple Myeloma
		23.1	 Introduction
		23.2	 Treatment Response Evaluation
			23.2.1	 Early Response
			23.2.2	 After Therapy
			23.2.3	 PET/CT and MRI
			23.2.4	 Minimal Residual Disease
			23.2.5	 Image Interpretation
			23.2.6	 Non-FDG Tracers
		23.3	 Multiple Myeloma Cases
		References
	24: 18F-FDG PET-CT and 18F-NaF in Treatment Response Evaluation: Bone Metastases and Bone Tumours
		24.1	 Introduction
		References
	25: FDG-PET/CT in Assessment of Treatment Response in Pediatric Lymphoma
		25.1	 Case 1
		25.2	 Case 2
		25.3	 Case 3
		25.4	 Case 4
		25.5	 Case 5
		25.6	 Case 6
		25.7	 Case 7
		References
	26: 18F-FDG PET/CT in Treatment Response Evaluation in Thyroid Cancer
		26.1	 Introduction
		26.2	 Case 1: 18F-FDG PET/CT After Thyroid Surgery
		26.3	 Case 2: Progressive Metastatic Disease After Local Radiotherapy
		26.4	 Case 3: Progressive Disease on Tyrosine Kinase Inhibitor (TKI)
		26.5	 Case 4: Thyroid Lymphoma
		26.6	 Case 5: Partial Response to Tyrosine Kinase Inhibitors with Increasing Lytic Metastatic Disease
		26.7	 Case 6: Interesting Finding in a Patient with Anaplastic Carcinoma
		References
			Introduction
			Case 1
			Case 2
			Case 3
			Case 4
			Case 5
			Case 6
	27: 68Ga-DOTA PET-CT in Treatment Response Evaluation: Neuroendocrine Tumours
		27.1	 Introduction
		27.2	 Clinical Examples
			27.2.1	 Case 1: 68Ga-DOTANOC PET/CT Biodistribution (Image 27.1)
			27.2.2	 Case 2: Restaging After Radical Surgery (Images 27.2 and 27.3)
			27.2.3	 Case 3: Restaging After Surgery (Image 27.4)
			27.2.4	 Case 4: Restaging on Somatostatin Analog Therapy (Images 27.5 and 27.6)
			27.2.5	 Case 5: Restaging After PRRT (Peptide Receptor Radionuclide Therapy) (Images 27.7 and 27.8)
			27.2.6	 Case 6: Ileum NET Restaging on Somatostatin Analog Therapy (Image 27.9)
			27.2.7	 Case 7: Nodal Relapse of a Well-Differentiated Ileum NET (Image 27.10) and Further Disease Progression on Somatostatin Analog Therapy (Image 27.11)
		27.3	 Case 8: Pancreatic NET G1 Studied Before and After PRRT (Partial Response) (Image 27.12)
			27.3.1	 Case 9: Pancreatic NET G2 Studied Before and After PRRT (Complete Response) (Image 27.13)
		27.4	 Case 10: Restaging After Everolimus Therapy (Image 27.14)
		Suggested Reading
			Case 1
			Case 2
			Case 3
			Case 4
			Case 5
			Case 6
			Case 7
			Case 8
			Case 9
			Case 10
	28: 18F-FDOPA PET/CT for Treatment Response Assessment
		28.1	 Case 1: Assessment of Response to Chemotherapy in a Patient with Metastatic Ganglioneuroblastoma
		28.2	 Case 2: Assessment of Antitumor Effect of Somatostatin Analogs in a Patient with Carcinoid Syndrome
		28.3	 Case 3: 18F-FDOPA PET/CT-Guided Radiofrequency Ablation of Liver Metastases
		28.4	 Case 4: Assessment of Response to Dopamine Agonists Treatment in a Patient with a MEN1-Related Prolactinoma
		28.5	 Case 5: Assessment of Response to Peptide Receptor Radionuclide Therapy in a SDHB-Related Metastatic Jugular Paraganglioma
		References
			Case 1
			Case 2
			Case 3
			Case 4
			Case 5
	29: 18F-FLT/FET PET-CT in Treatment Response Evaluation
		29.1	 Introduction
		29.2	 Limitations of FDG PET/CT
			29.2.1	 Amino Acid Tracers
			29.2.2	 FLT and FET PET/CT Imaging
			29.2.3	 Diagnosis and Grading
		29.3	 Response Assessment
			29.3.1	 Radiation Necrosis vs. Recurrence
			29.3.2	 Post Anti-angiogenic Therapy
			29.3.3	 Response to Immune Check-Point Inhibitors
		29.4	 Conclusion
		References