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01.12.2014 | Original Article

Tumor SUVmax Normalized to Liver Uptake on ¹⁸F-FDG PET/CT Predicts the Pathologic Complete Response After Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

verfasst von: Jihyun Park, Kyoung Jin Chang, Young Seok Seo, Byung Hyun Byun, Joon Ho Choi, Hansol Moon, Ilhan Lim, Byung Il Kim, Chang Woon Choi, Sang Moo Lim

Erschienen in: Nuclear Medicine and Molecular Imaging | Ausgabe 4/2014

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Abstract

Purpose

This study investigates the feasibility of using ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) to predict the pCR (pathologic complete response) rate after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced rectal cancer.

Methods

A total of 88 patients with locally advanced rectal cancer were retrospectively analyzed. All patients were treated with NCRT, followed by radical surgery, and ¹⁸F-FDG PET/CT was performed before and after NCRT. For a semiquantitative assessment, a volume of interest was drawn, including the whole tumor region, and the maximum SUV (SUVmax), SUVmax normalized to liver uptake (SLR), SUVmax normalized to blood pool uptake (SBR), the metabolic tumor volume at SUV 2.0 (MTV[2.0]), SUV 2.5 (MTV[2.5]), and SUV 3.0 (MTV[3.0]) were measured. In addition, their percentage changes after NCRT were assessed. The pCR was verified through a histologic examination of postsurgical specimens. A receiver operating characteristic curve analysis was conducted to predict the pCR by using these PET parameters.

Results

The pCR was predicted in 17 patients (19 %). The values of the area under the curve (AUC) for predicting the pCR were 0.774 for SUVmax after NCRT, 0.826 for SLR after NCRT, 0.815 for SBR after NCRT, 0.724 for MTV(2.5) after NCRT, 0.729 for the percentage change in SUVmax, 0.700 for the percentage change in SLR, and 0.749 for the percentage change in MTV (2.5). Among these PET parameters, SLR after NCRT showed the highest AUC value. The optimal criterion, sensitivity, specificity, and accuracy of SLR after NCRT for predicting the pCR were ≤1.41, 88 %, 65 %, and 68 %, respectively.

Conclusions

F-FDG PET was found to be useful for predicting the pCR after NCRT in patients with locally advanced rectal cancer. Among various PET parameters, SUVmax normalized to liver uptake after NCRT was the best predictor of the pCR.

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Titel: Tumor SUVmax Normalized to Liver Uptake on 18F-FDG PET/CT Predicts the Pathologic Complete Response After Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer
verfasst von: Jihyun Park
Kyoung Jin Chang
Young Seok Seo
Byung Hyun Byun
Joon Ho Choi
Hansol Moon
Ilhan Lim
Byung Il Kim
Chang Woon Choi
Sang Moo Lim
Publikationsdatum: 01.12.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Nuclear Medicine and Molecular Imaging / Ausgabe 4/2014
Print ISSN: 1869-3474
Elektronische ISSN: 1869-3482
DOI: https://doi.org/10.1007/s13139-014-0289-x

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Tumor SUVmax Normalized to Liver Uptake on ¹⁸F-FDG PET/CT Predicts the Pathologic Complete Response After Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer

Abstract

Purpose

Methods

Results

Conclusions

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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