Prospective Analysis of 18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery
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...
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| description | 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. |
| doi_str_mv | 10.1155/2014/952843 |
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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.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2014/952843</identifier><identifier>PMID: 24877151</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Puplishing Corporation</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Biomedical research ; Cancer ; Cancer therapies ; Chemotherapy ; Female ; Fluorodeoxyglucose F18 - administration & dosage ; Humans ; Male ; Medical imaging ; Medical prognosis ; Methods ; Middle Aged ; Mortality ; Neoadjuvant Therapy - methods ; Positron-Emission Tomography - methods ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Radiation therapy ; Radiography ; Radiopharmaceuticals - administration & dosage ; Rectal Neoplasms - diagnostic imaging ; Rectal Neoplasms - therapy ; Surgery ; Tomography ; Tumors</subject><ispartof>BioMed research international, 2014-01, Vol.2014 (2014), p.1-10</ispartof><rights>Copyright © 2014 Artor Niccoli-Asabella et al.</rights><rights>Copyright © 2014 Artor Niccoli-Asabella et al. Artor Niccoli-Asabella et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 Artor Niccoli-Asabella et al. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-0128-9745 ; 0000-0003-1972-3308</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024401/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024401/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24877151$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Hochwald, Steven N.</contributor><creatorcontrib>Niccoli Asabella, Artor</creatorcontrib><creatorcontrib>Altini, Corinna</creatorcontrib><creatorcontrib>De Luca, Raffaele</creatorcontrib><creatorcontrib>Fanelli, Margherita</creatorcontrib><creatorcontrib>Rubini, Domenico</creatorcontrib><creatorcontrib>Caliandro, Cosimo</creatorcontrib><creatorcontrib>Montemurro, Severino</creatorcontrib><creatorcontrib>Rubini, Giuseppe</creatorcontrib><title>Prospective Analysis of 18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>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.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomedical research</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18 - administration & dosage</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Positron-Emission Tomography - methods</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Radiation therapy</subject><subject>Radiography</subject><subject>Radiopharmaceuticals - 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diagnostic imaging</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomedical research</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18 - administration & dosage</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Positron-Emission Tomography - methods</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Radiation therapy</topic><topic>Radiography</topic><topic>Radiopharmaceuticals - administration & dosage</topic><topic>Rectal Neoplasms - diagnostic imaging</topic><topic>Rectal Neoplasms - therapy</topic><topic>Surgery</topic><topic>Tomography</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Niccoli Asabella, Artor</creatorcontrib><creatorcontrib>Altini, Corinna</creatorcontrib><creatorcontrib>De Luca, Raffaele</creatorcontrib><creatorcontrib>Fanelli, Margherita</creatorcontrib><creatorcontrib>Rubini, Domenico</creatorcontrib><creatorcontrib>Caliandro, Cosimo</creatorcontrib><creatorcontrib>Montemurro, Severino</creatorcontrib><creatorcontrib>Rubini, Giuseppe</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Niccoli Asabella, Artor</au><au>Altini, Corinna</au><au>De Luca, Raffaele</au><au>Fanelli, Margherita</au><au>Rubini, Domenico</au><au>Caliandro, Cosimo</au><au>Montemurro, Severino</au><au>Rubini, Giuseppe</au><au>Hochwald, Steven N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective Analysis of 18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>2014</volume><issue>2014</issue><spage>1</spage><epage>10</epage><pages>1-10</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>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.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Puplishing Corporation</pub><pmid>24877151</pmid><doi>10.1155/2014/952843</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0128-9745</orcidid><orcidid>https://orcid.org/0000-0003-1972-3308</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - therapy Adult Aged Aged, 80 and over Biomedical research Cancer Cancer therapies Chemotherapy Female Fluorodeoxyglucose F18 - administration & dosage Humans Male Medical imaging Medical prognosis Methods Middle Aged Mortality Neoadjuvant Therapy - methods Positron-Emission Tomography - methods Predictive Value of Tests Prognosis Prospective Studies Radiation therapy Radiography Radiopharmaceuticals - administration & dosage Rectal Neoplasms - diagnostic imaging Rectal Neoplasms - therapy Surgery Tomography Tumors |
| title | Prospective Analysis of 18F-FDG PET/CT Predictive Value in Patients with Low Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy and Conservative Surgery |
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