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- Title
The role of sequential 18<sup>F</sup>- FDG PET/ CT in predicting tumour response after preoperative chemoradiation for rectal cancer.
- Authors
Sun, W.; Xu, J.; Hu, W.; Zhang, Z.; Shen, W.
- Abstract
Aim The aim of this study was to investigate the potential of sequential positron emission tomography ( PET)/ CT standardized uptake value ( SUV)/metabolic area variation in predicting the pathological response to preoperative chemoradiotherapy ( CRT) for rectal cancer. Method Fifty-three patients diagnosed with clinical T3-4 and/or N+ rectal cancer were enrolled. All patients received CRT followed by radical surgery after 6-8 weeks. A PET/ CT scan was performed before ( PET/ CT1) initiation of treatment and a second scan ( PET/ CT2) was performed within 1 week after the completion of CRT. Thirty-five of 53 patients also underwent a third ( PET/ CT3) scan within 1 week before surgery. Maximal SUV within the tumour ( SUVmax), average SUV within the tumour ( SUVmean), metabolic tumour volume ( MV), total lesion glycolysis ( TLG) and response indices (∆%, i.e. the percentage difference between two different PET/ CT scans for SUVmax, SUVmean, MV and TLG) were calculated. The different metabolic parameters were analysed and correlated with the tumour regression grade ( TRG) score. Results When patients were regrouped as responders ( TRG 3-4) and nonresponders ( TRG 0-2), significant differences were observed in the percentage differences between PET/ CT1 and PET/ CT3 for MV (∆% MV(1-3); 91.08% vs 75.43%) and for TLG (∆% TLG(1-3); 94.00% vs 82.02%). As demonstrated by receiver-operating characteristics analysis, ∆% MV(1-3) and ∆% TLG(1-3) both had a strong capability to discriminate between responders and nonresponders. Patients classified as having a pathological complete response ( pCR) and a non- pCR showed significant differences in the percentage difference between PET/ CT1 and PET/ CT3 in SUVmax (∆% SUVmax(1-3); 69.17% vs 57.77%), SUVmean (∆% SUVmean(1-3); 44.20% vs 30.19%), ∆% MV(1-3) (90.93% vs 80.30%) and ∆% TLG(1-3) (94.22% vs 85.63%). ∆% TLG (1-3) was a more powerful discriminator than the others. Conclusion Differences in the SUV/metabolic area with 18 F-fluorodeoxyglucose (18F- FDG) PET/ CT have the potential to predict a response to preoperative CRT for rectal cancer.
- Publication
Colorectal Disease, 2013, Vol 15, Issue 5, pe231
- ISSN
1462-8910
- Publication type
Academic Journal
- DOI
10.1111/codi.12165