Nuklearmedizin 2025; 64(01): 78-79
DOI: 10.1055/s-0045-1804375
Abstracts │ NuklearMedizin 2025
Wissenschaftliche Vorträge
Onkologie – Bildgebung und Therapie

The PREMIO criteria: A further development of the PERCIST criteria for patient-centric response monitoring of solid tumors in PET/CT scans

Authors

  • S Hein

    1   Klinik und Poliklinik für Nuklearmedizin, TUM Universitätklinikum Klinikum rechts der Isar, München, Deutschland

  • N M Uhrbrand Moellerjakobsen

    2   Abteilung für Nuklearmedizin, Universitätsklinikum Odense, Odense, Dänemark

  • M Naghavi-Behzad

    2   Abteilung für Nuklearmedizin, Universitätsklinikum Odense, Odense, Dänemark

  • W Weber

    1   Klinik und Poliklinik für Nuklearmedizin, TUM Universitätklinikum Klinikum rechts der Isar, München, Deutschland

  • W Vach

    3   Basel Academy for Quality and Research in Medicine, Basel, Schweiz

  • M G Hildebrandt

    2   Abteilung für Nuklearmedizin, Universitätsklinikum Odense, Odense, Dänemark
    4   Department of Clinical Research, Syddansk Universitet, Odense, Dänemark

  • M Vogsen

    4   Department of Clinical Research, Syddansk Universitet, Odense, Dänemark
    5   Abteilung für Onkologie, Universitätsklinikum Odense, Odense, Dänemark
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Ziel/Aim: As the PERCIST criteria have been originally developed for the assessment of drug trials with a strongly generalized and study-centric approach, their application in clinical response monitoring is not fully suitable. We propose a further development of PERCIST with a more personalized and patient-centric focus for response monitoring aiming for a better individual assessment: the PREMIO (Personalised Response Monitoring In Oncology) criteria.

Methodik/Methods: Evolving from the one-lesion PERCIST, we further develop the criteria based on a prospectively acquired dataset of [18F]-FDG-PET/CT response monitoring cases of 87 metastatic breast cancer patients with a median of 6 follow-up scans [1] without change of therapy. For the determination of the suitable SULpeak increase for progression in the PREMIO criteria, the probability for false positive progression was minimized based on a regression analysis of the SULpeak values in stable periods of the patients. Ideal ground truth time point of progression has been determined by consent of two nuclear medicine physicians after validating the progression in the follow-up scans.

Ergebnisse/Results: Major changes in PREMIO with respect to PERCIST are: the introduction of the nadir scan with the lowest SULpeak as the reference scan for progression; the definition of measurability and comparability on scan level and between current scan and reference scan; a 50% SULpeak increase criterium for progression in comparison to nadir; the integration of a molecular imaging RADS for the assessment of new lesion (submitted to NuklearMedizin 25); and definitions for the progression based on anatomic increase and visual assessment. PREMIO is better suitable for clinical response monitoring than PERCIST with a PPV of 94% vs. 84% and a NPV of 100% vs. 63%.

Ergebnisse/Conclusion The new PREMIO criteria fill the gap for an objective and patient-centric response monitoring system of solid tumors PET/CT scans. The modular approach with possible different molecular imaging RADS also suggests the application in other tumor entities and other tracers than [18F]-FDG, which is to be further evaluated.



Publikationsverlauf

Artikel online veröffentlicht:
12. März 2025

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