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


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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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Statistical risk anlaysis for clinical outcomes using mid therapy fdg pet in sarcoma patients

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


Uw soft tissue sarcoma treatment protocol

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


Statistical risk anlaysis for clinical outcomes using mid therapy fdg pet in sarcoma patients

2-fluoro-2-deoxy-D-glucose

18FDG is the most important PET procedure

  •  FDG reflects altered tissue metabolism

More than just “grading” images.


Study patients

Study Patients


High grade sarcoma heterogeneous response to chemotherapy

High Grade Sarcoma: Heterogeneous Response to Chemotherapy


Study design analysis

: 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


Overall survival univariate models

Overall Survival (Univariate Models)


Overall survival reduced model

Overall Survival (reduced model)


Progression free survival reduced model

Progression-free Survival(Reduced model)


Local progression free survival reduced model

Local Progression-free Survival(reduced model)


Survival

Survival


Survival reduced model

Survival (reduced model)

Progression-free Survival

Local Progression-free Survival

Overall Survival


Survival risk multivariate model

Survival Risk (multivariate model)

Truncal tumors

Extremity tumors


Local progression free survival multivariate model

Local Progression-free Survival(Multivariate model)

Truncal tumors

Extremity tumors


Fdg pet risk assessment in sarcoma

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


Support your local molecular imaging center thanks

Support your local Molecular Imaging Center !(thanks.)


Progression free survival u nivariate models

Progression-Free Survival (univariate models)


Local progression free survival univariate models

Local Progression-free Survival(Univariate models)


Progression free survival multivariate model

Progression-free Survival(Multivariate model)

Truncal Tumors

Extremity Tumors


Survival risk

Survival Risk

Survival- extremity tumors

Survival- truncal tumors


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