scholarly journals Role of 18F-PET-CT to predict pathological response after neoadjuvant treatment of rectal cancer

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.

2021 ◽  
Author(s):  
Riccardo Caruso ◽  
Emilio Vicente ◽  
Yolanda Quijano ◽  
Hipolito Duran ◽  
Isabel Fabra ◽  
...  

Abstract Objectives: Neoadjuvant radiochemotherapy (nCRT) is universally considered to be a valid treatment to achieve downstaging, improve local disease control and obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in tumor 18F -FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of pathologic response (pR) achieved in patients with LARC.Data description: We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients received nCRT and surgical treatment was carried after 8/12th. All patients underwent a baseline 18F -FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-C T SUV2) within six weeks of the completion of nCRT. Furthermore, we evaluated the prognostic value of 18F -FDG PET-CT in terms of disease free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumor regression grade): 107 (80%) as Responders group (TRG0-TRG1) and 26 (25%) as the No-Responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups responders vs no responders (p<0.012).The results of this analysis have shown that 18F-FDG PET-CT may be an indicator in order to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumor may offer primary information in order to early identify those patients more likely to obtain a pCR to nCRT and predict those unlikely to regress significantly.


2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Artor Niccoli-Asabella ◽  
Corinna Altini ◽  
Raffaele De Luca ◽  
Margherita Fanelli ◽  
Domenico Rubini ◽  
...  

This study prospectively assessed18F-FDG PET/CT in predicting the response of locally advanced low rectal cancer (LRC) to neoadjuvant chemoradiation (nCRT).Methods. 56 patients treated with chemoradiation underwent two18F-FDG PET/CT scans (baseline and 5-6 weeks post-nCRT).18F-FDG uptake (SUVmax and SUVmean) and differences between baseline (SUV1) and post-nCRT (SUV2) scans (ΔSUV and RI%) were evaluated. Results were related to the Mandard’s TRG and (y)pTNM.Results.18F-FDG PET/CT sensitivity, specificity, accuracy, PPV and NPV resulted in 88.6%, 66.7%, 83.92%, 90.7%, and 61.5%. SUV2 resulted in better than SUV1 to predict nCRT response by TRG, with no significant statistical difference between the SUVmax2 and SUVmean2 AUC (0.737 versus 0.736;P=0.928). The same applies to the (y)pTNM (0.798 versus 0.782;P=0.192). In relation to the TRG, RI values had a higher AUC than ΔSUV, with no significant difference between RImax and RImean (0.672 versus 0.695;P=0.292). The same applied to the (y)pTNM (0.742 versus 0.741;P=0.940). In both cases ΔSUV does not appear to be a good predictive tool. Logistic regression confirmed the better predictive role of SUVmax2 for the (y)pTNM (odds ratio = 1.58) and SUVmean2 for the TRG (odds ratio = 1.87).Conclusions.18F-FDG PET/CT can evaluate response to nCRT in LRC, even if more studies are required to define the most significant parameter for predicting pathologic tumor changes.


2009 ◽  
Vol 36 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Luca Guerra ◽  
Rita Niespolo ◽  
Giuseppe Di Pisa ◽  
Davide Ippolito ◽  
Elena De Ponti ◽  
...  

2009 ◽  
Vol 185 (4) ◽  
pp. 260-265 ◽  
Author(s):  
Brigita Paskeviciute ◽  
Tobias Bölling ◽  
Markus Brinkmann ◽  
Ganna Rudykina ◽  
Iris Ernst ◽  
...  

2019 ◽  
Vol 58 (01) ◽  
pp. 28-38 ◽  
Author(s):  
Milena Cerny ◽  
Vincent Dunet ◽  
Caterina Rebecchini ◽  
Dieter Hahnloser ◽  
John Prior ◽  
...  

Abstract Aim To prospectively evaluate histological significance and predictive value of changes in apparent diffusion coefficient (ADC) and 18F-FDG PET/CT parameters in locally advanced rectal cancer (LARC) after neoadjuvant radiochemotherapy (RCT). Methods Twenty-one patients with untreated LARC underwent pre-RCT and post-RCT 18F-FDG PET/CT and diffusion-weighted magnetic resonance imaging (DW-MRI), followed by surgery. For both datasets, two readers measured the tumor SUVmax, SUVmean, MTV, TLG, ADCmin, ADCmean, and respective differences (∆SUVmax, ∆SUVmean, ∆MTV, ∆TLG, ∆ADCmin, ∆ADCmean) for the whole tumor. Tumor regression grade according to Mandard (TRGm), percentage of residual tumor cells and fibrosis were estimated by two pathologists in consensus. Relationship between parameters was assessed on stepwise multivariate regression analysis and ROC curve analysis to evaluate their performance and predict the treatment response. Results Eighteen LARCs were analyzed. SUVmax and SUVmean decreased from 21.3 ± 8.9 to 9.3 ± 5.5 g/mL, (p = 0.0002) and 12.3 ± 5.1 to 5.4 ± 3.1 g/mL, (p = 0.0002), respectively, after RCT, whereas ADCmin and ADCmean increased from 396 ± 269 to 573 ± 313×10–6 mm2/s (p = 0.014) and 1159 ± 212 to 1355 ± 194×10–6 mm2/s (p = 0.0008), respectively. TRGm and percentage of residual tumor cells independently correlated with post-RCT SUVmean (β = 0.73 and β = 0.76, p < 0.001) and post-RCT SUVmax (β = 0.72 and β = 0.78, p < 0.001), whereas percentage of fibrosis independently correlated with ∆ADCmean (β = 0.38, p = 0.008). Post-RCT, SUVmax and SUVmean performed well in predicting TRGm < 3 and residual tumor cells ≤ 20 %. ΔADCmean predicted fibrosis > 70 % well. Conclusion Post-RCT SUVmean, SUVmax and ∆ADCmean are complementary parameters for respectively evaluating residual tumor burden and amount of fibrosis in LARC. However, only SUV independently correlated with TRGm.


2012 ◽  
Vol 40 (1) ◽  
pp. 91-97 ◽  
Author(s):  
M. J. Murcia Duréndez ◽  
L. Frutos Esteban ◽  
J. Luján ◽  
M. D. Frutos ◽  
G. Valero ◽  
...  

2014 ◽  
Vol 99 (4) ◽  
pp. 309-318 ◽  
Author(s):  
Kei Ogino ◽  
Masanobu Nakajima ◽  
Miyako Kakuta ◽  
Mitsuhiro Hayashi ◽  
Satoru Yamaguchi ◽  
...  

Abstract Neoadjuvant chemotherapy (NAC) is effective in down-staging a primary tumor before surgery, and quick differentiation between responders to NAC and nonresponders is needed. We investigated the utility of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) in evaluating the therapeutic effectiveness of NAC. We investigated 25 patients who underwent NAC for stage II and III noninflammatory breast cancer. FDG-PET/CT was undertaken before and after NAC to determine the maximum standardized uptake value (SUVmax) reduction rate. Findings were compared with postoperative histopathologic evaluation of therapeutic response. It was not possible to accurately assess tumor response to NAC using CT. However, using the SUVmax reduction rate, we noted a significant difference (P = 0.0420) between patients who were responsive and nonresponsive to NAC. The sensitivity and specificity were as high as 83.3% and 78.9%, respectively. This study demonstrated that FDG-PET/CT can differentiate responders from nonresponders. This improves patient management by avoiding unnecessary chemotherapy.


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