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Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 3/2016

01.03.2016 | Original Article

Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer

verfasst von: Ji-In Bang, Seunggyun Ha, Sung-Bum Kang, Keun-Wook Lee, Hye-Seung Lee, Jae-Sung Kim, Heung-Kwon Oh, Ho-Young Lee, Sang Eun Kim

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2016

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Abstract

Purpose

The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC).

Methods

We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses.

Results

MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS.

Conclusion

Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity for the prediction of neoadjuvant radiation chemotherapy response and recurrence in LARC.
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Metadaten
Titel
Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer
verfasst von
Ji-In Bang
Seunggyun Ha
Sung-Bum Kang
Keun-Wook Lee
Hye-Seung Lee
Jae-Sung Kim
Heung-Kwon Oh
Ho-Young Lee
Sang Eun Kim
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2016
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3180-9

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