F-18 FDG PET/CT in Rectal Carcinoma

Grassetto, Gaia; Marzola, Maria Cristina; Minicozzi, Annamaria; Al‐Nahhas, Adil; Rubello, Domenico

doi:10.1097/rlu.0b013e318219b507

Cited by 18 publications

(10 citation statements)

References 16 publications

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“…Low rectal cancer (LRC) can benefit from neoadjuvant chemoradiotherapy (nCRT) treatments for downstaging purposes [1, 2]. nCRT regimens in patients with locally advanced LRC are intended to control pelvic disease and to improve the chance of sphincter preservation at subsequent surgery, thereby improving overall survival [3–5].…”

Section: Introductionmentioning

confidence: 99%

Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Asabella

Altini

Luca

et al. 2014

BioMed Research International

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This study prospectively assessed 18F-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 two 18F-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.

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Section: Introductionmentioning

confidence: 99%

Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Asabella

Altini

Luca

et al. 2014

BioMed Research International

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“…In PET-CT, the standardized uptake value (SUV) is a measure of fluorodeoxyglucose (FDG) uptake, which has been shown to be helpful in establishing the metabolic activity level of a tumor (13)(14)(15).…”

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confidence: 99%

Correlation of minimum apparent diffusion coefficient with maximum standardized uptake on fluorodeoxyglucose PET-CT in patients with rectal adenocarcinoma

Erden²,

No³

et al. 2013

Diagn Interv Radiol

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ABDOMINAL IMAGINGORIGINAL ARTICLE PURPOSE The aim of this study was to retrospectively assess the correlation between minimum apparent diffusion coefficient (ADC min ) values obtained from diffusion-weighted magnetic resonance imaging (MRI) and maximum standardized uptake values (SUV max ) obtained from positron emission tomography-computed tomography (PET-CT) in rectal cancer. MATERIALS AND METHODSForty-one patients with pathologically confirmed rectal adenocarcinoma were included in this study. For preoperative staging, PET-CT and pelvic MRI with diffusion-weighted imaging were performed within one week (mean time interval, 3±1 day). For ADC measurements, the region of interest (ROI) was manually drawn along the border of each hyperintense tumor on b=1000 s/mm 2 images. After repeating this procedure on each consecutive tumor-containing slice to cover the entire tumoral area, ROIs were copied to ADC maps. ADC min was determined as the lowest ADC value among all ROIs in each tumor. For SUV max measurements, whole-body images were assessed visually on transaxial, sagittal, and coronal images. ROIs were determined from the lesions observed on each slice, and SUV max values were calculated automatically. The mean values of ADC min and SUV max were compared using Spearman's test. RESULTSThe mean ADC min was 0.62±0.19×10 -3 mm 2 /s (range, 0.368-1.227×10 -3 mm 2 /s), the mean SUV max was 20.07±9.3 (range, 4.3-49.5). A significant negative correlation was found between ADC min and SUV max (r=-0.347; P = 0.026). CONCLUSIONThere was a significant negative correlation between the ADC min and SUV max values in rectal adenocarcinomas. D iffusion-weighted imaging (DWI) is a widely used technique for disease evaluation in oncology (1, 2). In rectal cancer, the applications of DWI include tumor detection, tumor characterization, distinguishing tumor tissue from nontumor tissue, and monitoring and predicting treatment response (3-8). For local staging of rectal cancer, adding DWI to conventional magnetic resonance imaging (MRI) yields better identification of tumor borders and locoregional lymph nodes than conventional MRI alone (9, 10).The apparent diffusion coefficient (ADC) map obtained from DWI shows the freedom of water diffusion, and values calculated on the map are useful parameters in tissue characterization. By performing diffusion-weighted (DW) MRI with at least two diffusion weightings, or b values, the differential signal attenuation at different b values can be used to calculate the ADC (2). Regardless of the tumor type and location, the ADC values reflect tumor morphology, including the cellular density, integrity of cell membrane, and nuclear-to-cytoplasm ratio (11,12).Positron emission tomography/computed tomography (PET-CT) has become a crucial method in cancer imaging, both for diagnosis and staging, as well as for offering prognostic information based on tumor response. In PET-CT, the standardized uptake value (SUV) is a measure of fluorodeoxyglucose (FDG) uptake, which has been shown to be helpful in estab...

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“…In unclear lesions, colonoscopy with histological examination remains the diagnostic gold standard. In suitable cases of histology-confirmed colorectal carcinomas, combined metabolic/anatomical imaging with FDG-PET/CT may become useful for staging and for assessing the treatment response to neoadjuvant radiochemotherapy 3. However, currently there are no guidelines that are generally accepted, so that a conservative attitude seems wise.…”

Section: Discussionmentioning

confidence: 99%

18F-FDG PET/CT of a rectal carcinoma and a sigmoid adenoma

Menke

Schaefer

Sahlmann

2013

Postgraduate Medical Journal

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F-18 FDG PET/CT in Rectal Carcinoma

Cited by 18 publications

References 16 publications

Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Correlation of minimum apparent diffusion coefficient with maximum standardized uptake on fluorodeoxyglucose PET-CT in patients with rectal adenocarcinoma

18F-FDG PET/CT of a rectal carcinoma and a sigmoid adenoma

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F-18 FDG PET/CT in Rectal Carcinoma

Cited by 18 publications

References 16 publications

Prospective Analysis of18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Prospective Analysis of18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Correlation of minimum apparent diffusion coefficient with maximum standardized uptake on fluorodeoxyglucose PET-CT in patients with rectal adenocarcinoma

18F-FDG PET/CT of a rectal carcinoma and a sigmoid adenoma

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Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery

Prospective Analysis of¹⁸F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery