BACKGROUND AND PURPOSE: More effective preoperative treatment in locally advanced rectal cancer gives rise to a more individualized, conservative surgical treatment strategy. This, however, requires accurate information on tumor response after chemoradiation (CRT). So far, MRI and CT have failed to provide such information. Therefore, the value of a combined FDG-PET/CT in predicting tumor clearance of the mesorectal fascia (MRF) was determined. PATIENTS AND METHODS: 20 rectal cancer patients with MRF tumor invasion underwent preoperative PET/CT before and on average 6.3 weeks after CRT. The SUV(max)(maximal standard uptake value) on sequential PET/CT and the shortest distance between the outlined tumor volume and the MRF measured by using autocontouring software on post-CRT PET/CT were registered. The surgical specimen was evaluated for tumor clearance of the MRF and the tumor regression grade (TRG). RESULTS: The TRG significantly corresponded with the SUV(max)changes induced by CRT (p = 0.025), and showed a trend with the post-CRT SUV(max)(TRG 1-2 vs. TRG 3-5: SUV(max)= 3.0 vs. 5.0; p = 0.06). However, the pathologically verified tumor clearance of the MRF was not correlated with any of the tested SUV parameters nor with the shortest distance between the residual tumor and the MRF. CONCLUSION: Post-CRT PET/CT is not a useful tool for evaluating anatomic tumor changes and, therefore, not accurate in predicting tumor clearance of the MRF. However, it might be a useful tool in predicting pathologic tumor response after CRT.
BACKGROUND AND PURPOSE: More effective preoperative treatment in locally advanced rectal cancer gives rise to a more individualized, conservative surgical treatment strategy. This, however, requires accurate information on tumor response after chemoradiation (CRT). So far, MRI and CT have failed to provide such information. Therefore, the value of a combined FDG-PET/CT in predicting tumor clearance of the mesorectal fascia (MRF) was determined. PATIENTS AND METHODS: 20 rectal cancerpatients with MRF tumor invasion underwent preoperative PET/CT before and on average 6.3 weeks after CRT. The SUV(max)(maximal standard uptake value) on sequential PET/CT and the shortest distance between the outlined tumor volume and the MRF measured by using autocontouring software on post-CRT PET/CT were registered. The surgical specimen was evaluated for tumor clearance of the MRF and the tumor regression grade (TRG). RESULTS: The TRG significantly corresponded with the SUV(max)changes induced by CRT (p = 0.025), and showed a trend with the post-CRT SUV(max)(TRG 1-2 vs. TRG 3-5: SUV(max)= 3.0 vs. 5.0; p = 0.06). However, the pathologically verified tumor clearance of the MRF was not correlated with any of the tested SUV parameters nor with the shortest distance between the residual tumor and the MRF. CONCLUSION: Post-CRT PET/CT is not a useful tool for evaluating anatomic tumor changes and, therefore, not accurate in predicting tumor clearance of the MRF. However, it might be a useful tool in predicting pathologic tumor response after CRT.
Authors: Felipe A Calvo; Claudio V Sole; Dolores de la Mata; Luis Cabezón; Marina Gómez-Espí; Emilio Alvarez; Paz Madariaga; José L Carreras Journal: Eur J Nucl Med Mol Imaging Date: 2013-02-23 Impact factor: 9.236
Authors: Guido Lammering; Dirk De Ruysscher; Angela van Baardwijk; Brigitta G Baumert; Jacques Borger; Ludy Lutgens; Piet van den Ende; Michel Ollers; Philippe Lambin Journal: Strahlenther Onkol Date: 2010-08-30 Impact factor: 3.621
Authors: Hendrik Andreas Wolff; Jochen Gaedcke; Klaus Jung; Robert Michael Hermann; Hilka Rothe; Markus Schirmer; Torsten Liersch; Markus Karl Alfred Herrmann; Steffen Hennies; Margret Rave-Fränk; Clemens Friedrich Hess; Hans Christiansen Journal: Strahlenther Onkol Date: 2009-12-28 Impact factor: 3.621