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STATISTICAL RISK ANLAYSIS FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS

Janet Eary 1 , Janet O'Sullivan 3 , Finbarr O'Sullivan 3 , E. U. Conrad 2 1. Nuclear Medicine/Radiology, University of Washington, Seattle, WA, United States. 2. Orthopedics, University of Washington, Seattle, WA, United States. 3. Statistics, University College Cork, Cork, Ireland.

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STATISTICAL RISK ANLAYSIS FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS

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  1. Janet Eary1, Janet O'Sullivan3, Finbarr O'Sullivan3, E. U. Conrad21. Nuclear Medicine/Radiology, University of Washington, Seattle, WA, United States. 2. Orthopedics, University of Washington, Seattle, WA, United States. 3. Statistics, University College Cork, Cork, Ireland STATISTICAL RISK ANLAYSIS FOR CLINICAL OUTCOMES USING MID-THERAPY FDG PET IN SARCOMA PATIENTS

  2. UW Soft Tissue Sarcoma Treatment Protocol • Large Intermediate and High grade Tumors • pre-resection 4 chemotherapy cycles • Tumor resection • 4 additional cycles of chemotherapy • 3 FDG PET scans to monitor response

  3. 2-fluoro-2-deoxy-D-glucose 18FDG is the most important PET procedure •  FDG reflects altered tissue metabolism More than just “grading” images.

  4. Study Patients

  5. High Grade Sarcoma: Heterogeneous Response to Chemotherapy

  6. : Study : Design : Analysis : • Aims: determine the value of the mid-therapy FDG PET scan for risk assessment for outcome • Hypothesis: the mid-therapy FDG PET scan will add predictive value to outcome prediction • Methods: Prospective study Univariate, and multivariate analyses with Cox proportional Hazards analysis, and models for variables for data reduction Creation of clinical risk scenarios for different sets of clinical variable combinations

  7. Overall Survival (Univariate Models)

  8. Overall Survival (reduced model)

  9. Progression-free Survival(Reduced model)

  10. Local Progression-free Survival(reduced model)

  11. Survival

  12. Survival (reduced model) Progression-free Survival Local Progression-free Survival Overall Survival

  13. Survival Risk (multivariate model) Truncal tumors Extremity tumors

  14. Local Progression-free Survival(Multivariate model) Truncal tumors Extremity tumors

  15. FDG PET Risk Assessment in Sarcoma Conclusions: • The mid-therapy scan provides additional information for risk assessment based on FDG PET and clinical variables • In addition to overall and progression-free survival, local recurrence risk can be assessed • Reduced Hazards and multivariate models for risk assessments provide clinically useful data on an individual patient. Future Directions: • Comparison/inclusion of other risk assessment models into these analysis results • Descriptions of tumor subtype and specific responses to therapy types. • Use of tumor image regional analysis to assess areas at risk for local recurrence and metastases

  16. Support your local Molecular Imaging Center !(thanks.)

  17. Progression-Free Survival (univariate models)

  18. Local Progression-free Survival(Univariate models)

  19. Progression-free Survival(Multivariate model) Truncal Tumors Extremity Tumors

  20. Survival Risk Survival- extremity tumors Survival- truncal tumors

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