The role of 18F-FDG-PET/CT in predicting the histopathological response in locally advanced cervical carcinoma treated by chemo-radiotherapy followed by radical surgery: a prospective study

Rufini, Vittoria; Collarino, Angela; Calcagni, Maria Lucia; Meduri, G; Fuoco, Valentina; Pasciuto, Tina; Testa, Antonia Carla; Ferrandina, Gabriella; Gambacorta, Maria Antonietta; Campitelli, M.; Gui, Benedetta; Zannoni, Gianfranco; Manfredi, Riccardo; Giordano, Alessandro

doi:10.1007/s00259-019-04436-y

Cited by 21 publications

(28 citation statements)

References 42 publications

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“…FDG, by glucose transporters [7][8][9] . The RECIST criteria have been widely used for evaluating the clinical response to chemotherapy in solid tumors 10 .…”

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confidence: 99%

L-type amino acid transporter 1 is associated with chemoresistance in breast cancer via the promotion of amino acid metabolism

Sato

Harada-Shoji

Toyohara

et al. 2021

Sci Rep

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Abstract18F-FDG PET/CT has been used as an indicator of chemotherapy effects, but cancer cells can remain even when no FDG uptake is detected, indicating the importance of exploring other metabolomic pathways. Therefore, we explored the amino acid metabolism, including L-type amino acid transporter-1 (LAT1), in breast cancer tissues and clarified the role of LAT1 in therapeutic resistance and clinical outcomes of patients. We evaluated LAT1 expression before and after neoadjuvant chemotherapy and examined the correlation of glucose uptake using FDG-PET with the pathological response of patients. It revealed that LAT1 levels correlated with proliferation after chemotherapy, and amino acid and glucose metabolism were closely correlated. In addition, LAT1 was considered to be involved in treatment resistance and sensitivity only in luminal type breast cancer. Results of in vitro analyses revealed that LAT1 promoted amino acid uptake, which contributed to energy production by supplying amino acids to the TCA cycle. However, in MCF-7 cells treated with chemotherapeutic agents, oncometabolites and branched-chain amino acids also played a pivotal role in energy production and drug resistance, despite decreased glucose metabolism. In conclusion, LAT1 was involved in drug resistance and could be a novel therapeutic target against chemotherapy resistance in luminal type breast cancer.

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“…FDG, by glucose transporters [7][8][9] . The RECIST criteria have been widely used for evaluating the clinical response to chemotherapy in solid tumors 10 .…”

mentioning

confidence: 99%

L-type amino acid transporter 1 is associated with chemoresistance in breast cancer via the promotion of amino acid metabolism

Sato

Harada-Shoji

Toyohara

et al. 2021

Sci Rep

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“…Rufini et al concluded that it is possible to evaluate the metabolic changes driven by treatment by performing 18F-FDG-PET/CT before, after, and during treatment in patients with LACC and assessing delta SUV Contrast Media & Molecular Imaging parameters. However, they showed that the final assessment was not accurate enough to predict the pathological CR of the primary tumor [16]. Another study examined 25 patients with LACC (stages IB2-IIIB), evaluated them using both MRI and 18F-FDG PET/CT, before and after CRT, and indicated that 18F-FDG PET/CT provided important information which led to treatment planning changes in half of the patients.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of 18F-FDG-PET/CT and MRI in Predicting the Tumor Response in Locally Advanced Cervical Carcinoma Treated by Chemoradiotherapy: A Meta-Analysis

Sistani

Parooie

Salarzaei

2021

Contrast Media & Molecular Imaging

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Objective. The aim of this meta-analysis was to compare the diagnostic accuracy of 18F-FDG-PET/CT and MRI in predicting the tumor response in locally advanced cervical carcinoma (LACC) treated by chemoradiotherapy (CRT). Method. This meta-analysis has been performed according to PRISMA guidelines. Systematic searches were conducted using PubMed and Embase databases for articles published from January 1, 2010, to January 1, 2020. By using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool, the reviewers assessed the methodological quality scores of the selected studies. We analyzed the sensitivity, specificity, and accuracy of two diagnostic methods using Meta-DiSc 1.4 and Stata 15. Results. An overall of 15 studies including 1132 patients were included. Sensitivities of PET/CT and MRI were 83.5% and 82.7%, while the corresponding rates for specificities were 77.8% and 68.4%, respectively. The DOR, PLR, and NLR for MRI were 15.140, 2.92, and 22.6. PET/CT had a DOR of 25.21. The PLR and NLR for PET/CT were 4.13 and 0.215, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of residual tumor were 86% and 95%, respectively. The corresponding rates for MRI were 73% and 96%, respectively. The diagnostic sensitivity and specificity of PET/CT for the detection of tumor metastases were 97% and 99%, while the corresponding rates for MRI were 31% and 98%, respectively. Conclusion. 18F-FDG PET/CT seemed to have a better overall diagnostic accuracy in the evaluation of treatment response to chemoradiotherapy in LACC patients. MRI showed a really poor sensitivity in the detection of metastases, and PET/CT performed significantly better. However, the difference between these two methods in the detection of residual disease was not significant. More studies are needed to be conducted in order to approve that 18F-FDG PET/CT can be a standard option to assess the treatment response.

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“…Patients with cervical cancer with a high SUVmax primary lesion show a worse prognosis [14,15]. The baseline SUVmean can effectively predict the histopathological partial response of the primary tumour in LACC patients treated with CRT followed by surgery, suggesting the potential role of 18 F-FDG PET/CT in personalized treatment [16]. Pre-treatment MTV and TLG are predictors of response to therapy and are associated with OS in cervical cancer patients treated with CRT [17,18].…”

Section: Introductionmentioning

confidence: 99%

The role of the metabolic parameters of pre-treatment 18F-FDG PET/CT in patients with locally advanced cervical cancer

Wang

Liu

Wang

et al. 2020

Preprint

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Abstract Purpose The purpose of the present study was to evaluate the role of the pre-treatment metabolic parameters of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) in patients with locally advanced cervical cancer (LACC) treated with definitive concurrent chemoradiotherapy (CCRT) or radiotherapy. Methods Patients with LACC who underwent pre-treatment 18F-FDG PET/CT examination and definitive CCRT or radiotherapy between February 2010 and December 2015 in our institute were enrolled. For each patient, the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of the primary tumour were measured. The survival outcomes were calculated with the Kaplan-Meier method. Cox proportional hazards models were used for univariate and multivariate analyses. Results A total of 125 patients were finally included in this study. The median follow-up duration was 62 months (range, 4-114 months). The 5-year overall survival (OS), disease-free survival (DFS), local control (LC) and distant metastasis-free survival (DMFS) rates were 83.6%, 75.1%, 92.3% and 79.9%, respectively. Univariate analysis indicated that MTV ≥ 18.3 cm3 showed worse OS and DMFS; however, no significant differences were identified for OS and DMFS in multivariate analyses. TLG ≥ 113.4 implied worse DFS and DMFS. In multivariate analysis, TLG ≥ 113.4 was an independent predictive factor for OS, DFS and DMFS. SUVmax and SUVmean had no significant influence on OS, DFS, LC or DMFS in either univariate or multivariate analysis. Conclusion Pre-treatment TLG ≥ 113.4 was associated with a high incidence of disease recurrence and poor OS in patients with LACC.

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The role of 18F-FDG-PET/CT in predicting the histopathological response in locally advanced cervical carcinoma treated by chemo-radiotherapy followed by radical surgery: a prospective study

Cited by 21 publications

References 42 publications

L-type amino acid transporter 1 is associated with chemoresistance in breast cancer via the promotion of amino acid metabolism

L-type amino acid transporter 1 is associated with chemoresistance in breast cancer via the promotion of amino acid metabolism

Diagnostic Accuracy of 18F-FDG-PET/CT and MRI in Predicting the Tumor Response in Locally Advanced Cervical Carcinoma Treated by Chemoradiotherapy: A Meta-Analysis

The role of the metabolic parameters of pre-treatment 18F-FDG PET/CT in patients with locally advanced cervical cancer

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