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- Title
Change in glucose metabolism measured by 18F-FDG PET/CT as a predictor of histopathologic response to neoadjuvant treatment in rectal cancer.
- Authors
Guerra, Luca; Niespolo, Rita; Pisa, Giuseppe; Ippolito, Davide; Ponti, Elena; Terrevazzi, Sara; Bovo, Giorgio; Sironi, Sandro; Gardani, Gianstefano; Messa, Cristina
- Abstract
Purpose: In order to analyze the changes of glucose metabolism by maximum standardized uptake value (SUVmax) of 18F-FDG PET/CT in patients with rectal cancer submitted to neoadjuvant radiochemotherapy (nRCT) and to correlate SUV changes with tumor regression grade (TRG). Methods and material: Three sequential 18F-FDG PET/CT studies were performed in 31 patients with rectal cancer at the following time point: before starting the treatment (PET/CT1), during the treatment (PET/CT2), and after completion of neoadjuvant treatment (PET/CT3). The SUVmax values of the rectal lesion in the PET/CT1 (SUV1), PET/CT2 (SUV2), and PET/CT3 (SUV3) were obtained; deltaSUV1 [(SUV1 − SUV2)/SUV1] and deltaSUV2 [(SUV1 − SUV3)/SUV1] were also calculated. Metabolic parameters were compared to TRG. Results: Significant differences in pathologic responder and non-responder patients were found only for SUV2 (6.4 ± 2.9 in responder and 10.7 ± 4.8 in non-responder patients, respectively; P = 0.006) and SUV3 (3.6 ± 1.4 in responder and 6.6 ± 2.1 in non-responder patients, respectively; P = 0.0009). The best predictor for TRG response was SUV3 (threshold of 4.4) with sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 77.3%, 88.9%, 80.7%, 61.5%, and 94.4%, respectively. Conclusion: 18F-FDG PET/CT is a reliable and accurate technique to assess the response to nRCT in rectal cancer. In our population, the absolute value of SUVmax after treatment was the best predictor of pathological response.
- Subjects
RECTAL cancer treatment; GLUCOSE; METABOLISM; HISTOPATHOLOGY; TOMOGRAPHY; DRUG therapy; RADIOLOGY
- Publication
Abdominal Imaging, 2011, Vol 36, Issue 1, p38
- ISSN
0942-8925
- Publication type
Article
- DOI
10.1007/s00261-009-9594-8