Prognostic utility of serial 18F-FDG-PET/CT in patients with locally advanced rectal cancer who underwent tri-modality treatment

Fernando, S.; Lin, Michael; Pham, Toan M.; Chong, Shanley; Ip, Emilia; Wong, Karen; Chua, Wei; Ng, Wan; Lin, Peter; Lim, Stephanie

doi:10.1259/bjr.20190455

Cited by 10 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, we found that post-TLG had a negative predictive value of 92.59% for GR status in LARC patients, but did not show a predictive advantage in pCR status. In previous studies, there have been meaningful reports about MTV, DMTV and DTLG in predicting the responsiveness of LARC patients to nCRT (8,(25)(26)(27). However, in our study, none of these three parameters was found to have meaningful predictive value in our study.…”

Section: Discussioncontrasting

confidence: 89%

The reduction of 18F-FDG uptake ability of tumor tissue after neoadjuvant chemoradiotherapy in locally advanced rectal cancer can effectively reflect the degree of tumor regression

Zhang

Yang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

IntroductionTo evaluate the predictive value of 18F-fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET-CT) imaging parameters for the response to neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC).MethodsFrom January 2016 to March 2020, 52 LARC patients who underwent 18F-FDG PET-CT scans within 1 week before and 8-9 weeks after nCRT, were enrolled in this study according to a pre-designed screening criteria. After total mesorectal excision (TME) surgery, we assessed tumor response to treatment and analyzed the correlation between imaging parameters obtained from two PET-CT scans and tumor regression status.ResultsTumor response assessment showed that 13 of 52 patients received good response (GR), including 9 cases with pathological complete regression (pCR) and 4 cases with near-pathological complete regression (near-pCR). We also found that the maximum standard uptake value after nCRT (post-SUVmax), the response index (RI), the mean standard uptake values after nCRT (post-SUVmean), and the ratio of tumor SUVmean to liver SUVmean after nCRT (post-Ratio), were correlated with GR and pCR. Among these parameters, post-SUVmax and RI had a near-strong correlation with pCR (rs= -0.58 and 0.59, respectively), and also had a strong correlation with GR (rs = -0.7 and 0.63, respectively). Further ROC analysis showed that post-SUVmax and RI had higher values in predicting whether patients could achieve GR and pCR after nCRT, and the area under the curve (AUC) of both were greater than 0.9. The positive predictive values (PPVs) and negative predictive values (NPVs) of post-SUVmax for GR were 80.01% and 97.3%, and for pCR were 66.68% and 97.5%, respectively. The PPVs and NPVs of the RI values for GR were 84.61% and 94.87%, and for pCR were 69.24% and 100%, respectively.ConclusionFor LARC patients, the analysis of imaging parameters such as post-SUVmax and RI, which can reflect the changes of 18F-FDG uptake capacity of tumor tissues before and after nCRT, is of great value for predicting the response of patients to neoadjuvant therapy and guiding the selection of subsequent treatment strategies.

show abstract

Section: Discussioncontrasting

confidence: 89%

The reduction of 18F-FDG uptake ability of tumor tissue after neoadjuvant chemoradiotherapy in locally advanced rectal cancer can effectively reflect the degree of tumor regression

Zhang

Yang

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…The metabolic tumor volume (MTV) was defined as the hypermetabolic tissue volume with a threshold of 42% of the SUVmax ( 19 ). The total lesion glycolysis (TLG) was calculated according to the formula: TLG = SUVmean × MTV ( 20 ). For the ADC measurement, the region of interest (ROI) was drawn manually along the edge of the largest tumor area section on the DWI image with a b-value of 800 s/mm 2 .…”

Section: Methodsmentioning

confidence: 99%

Correlation between apparent diffusion coefficient and tumor-stroma ratio in hybrid 18F-FDG PET/MRI: preliminary results of a rectal cancer cohort study

Xing

Liu

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: To explore possible correlations between the tumor-stroma ratio (TSR) and different imaging features of fluorine-18-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ( 18 F-FDG PET/MRI) in untreated rectal cancer patients.Methods: A patients with rectal cancer were included in this study. All participants were examined preoperatively with whole-body 18 F-FDG PET/MRI. Two pathologists evaluated the TSR of tumors together. Apparent diffusion coefficient (ADC) values and PET-related parameters of the primary lesions were measured and compared between the stroma-high and stroma-low groups. Pearson's correlation or Spearman's rank correlation were used to evaluate the correlation between the ADC values, PET-related parameters, and pathological indices.Results: Our results showed that in the untreated rectal cancer patients, the ADC mean values correlated with the TSR (r=0.327; P=0.007), and stroma-high (low TSR) rectal cancer corresponded to relatively lower ADC mean values (813.54±88.68 vs. 879.92±133.18; P=0.018). The ADC mean and ADC minimum (ADCmin) values were found to be negatively correlated with the pathological T stages (r=−0.384, P=0.001; r=−0.416, P=0.001, respectively) as well as the largest tumor diameters (r=−0.340, P=0.005; r=−0.314, P=0.010, respectively) of rectal cancer. In addition, the pathological T stages correlated with all PET-related metabolic parameters, including mean standard uptake value (SUV), maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) (r=0.338, P=0.006; r=0.350, P=0.004; r=0.326, P=0.007; and r=0.472, P<0.001, respectively). Our results also identified associations between the ADCmin values and SUVmean, SUVmax, P=0.006; P=0.005; P=0.005, respectively). However, there were no statistical correlations between the PET/MRI parameters and the immunohistochemical (IHC) results.Conclusions: This study indicated that the intratumoral heterogeneity measured by PET/MRI may reflect characteristics of the tumor microenvironment. Hence, PET/MRI parameters might be helpful in predicting tumor aggressiveness and prognosis.

show abstract

“…Only 25 patients (76%) had DCE MRI after CRT. Although the study did not formally collect information on reasons why patients declined MRI during and after CRT, a commonly cited reason was that patients wanted to focus on treatment and surgery, and did not want to undergo extra trial investigations, which in this study included MRI, positron emission tomography [33] and circulating tumour cells at three timepoints. Despite the small sample size, we found that DCE MRI after CRT was statistically significant for predicting DFS.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Contrast-enhanced Magnetic Resonance Imaging Evaluation of Whole Tumour Perfusion Heterogeneity Predicts Distant Disease-free Survival in Locally Advanced Rectal Cancer

et al. 2022

View full text Add to dashboard Cite

Prognostic utility of serial 18F-FDG-PET/CT in patients with locally advanced rectal cancer who underwent tri-modality treatment

Cited by 10 publications

References 27 publications

The reduction of 18F-FDG uptake ability of tumor tissue after neoadjuvant chemoradiotherapy in locally advanced rectal cancer can effectively reflect the degree of tumor regression

The reduction of 18F-FDG uptake ability of tumor tissue after neoadjuvant chemoradiotherapy in locally advanced rectal cancer can effectively reflect the degree of tumor regression

Correlation between apparent diffusion coefficient and tumor-stroma ratio in hybrid 18F-FDG PET/MRI: preliminary results of a rectal cancer cohort study

Dynamic Contrast-enhanced Magnetic Resonance Imaging Evaluation of Whole Tumour Perfusion Heterogeneity Predicts Distant Disease-free Survival in Locally Advanced Rectal Cancer

Contact Info

Product

Resources

About