PURPOSE: Recent literature suggests that tumor cells and areas within tumors with a high initial FDG uptake might be more resistant to (chemo)radiotherapy ((C)RT). This study was undertaken to test this hypothesis in rectal cancer using rigid and non-rigid image registration. PATIENTS AND METHODS: Twenty-eight patients, diagnosed with locally advanced rectal cancer and referred for pre-operative treatment with CRT were included in this study. All patients underwent FDG-PET-CT imaging prior to and after CRT. Rigid and non-rigid image registration was performed to compensate organ deformations between the pre- and post-treatment PET-CT scans. The tumor was contoured on both PET-scans using SUV iso-contouring based on the SBR-method. The voxels with residual increased FDG uptake were studied and correlated to their pre-treatment FDG uptake level. Two SUV-volume-histograms were made based on the pre-treatment PET-data, one for the voxels within the pre-treatment tumor PET-based iso-contour and one for the voxels within the PET-based iso-contour of the residual tumor non-rigidly registered onto the pre-treatment scan. RESULTS: For the voxels with a pre-treatment FDG uptake of >50% of SUV(max), 70.6±5.6% of the voxels were still metabolic active in the residual tumor, whereas for voxels with an FDG uptake of <50% of SUV(max) only 51.1±6.7% were present in the metabolic active residual tumor. CONCLUSION: This study presents areas in rectal tumors with an initially high FDG uptake to be most likely to show residual disease after CRT. This could indicate a higher (C)RT-resistance for tumor regions with a high FDG uptake prior to treatment.
PURPOSE: Recent literature suggests that tumor cells and areas within tumors with a high initial FDG uptake might be more resistant to (chemo)radiotherapy ((C)RT). This study was undertaken to test this hypothesis in rectal cancer using rigid and non-rigid image registration. PATIENTS AND METHODS: Twenty-eight patients, diagnosed with locally advanced rectal cancer and referred for pre-operative treatment with CRT were included in this study. All patients underwent FDG-PET-CT imaging prior to and after CRT. Rigid and non-rigid image registration was performed to compensate organ deformations between the pre- and post-treatment PET-CT scans. The tumor was contoured on both PET-scans using SUV iso-contouring based on the SBR-method. The voxels with residual increased FDG uptake were studied and correlated to their pre-treatment FDG uptake level. Two SUV-volume-histograms were made based on the pre-treatment PET-data, one for the voxels within the pre-treatment tumor PET-based iso-contour and one for the voxels within the PET-based iso-contour of the residual tumor non-rigidly registered onto the pre-treatment scan. RESULTS: For the voxels with a pre-treatment FDG uptake of >50% of SUV(max), 70.6±5.6% of the voxels were still metabolic active in the residual tumor, whereas for voxels with an FDG uptake of <50% of SUV(max) only 51.1±6.7% were present in the metabolic active residual tumor. CONCLUSION: This study presents areas in rectal tumors with an initially high FDG uptake to be most likely to show residual disease after CRT. This could indicate a higher (C)RT-resistance for tumor regions with a high FDG uptake prior to treatment.
Authors: Uulke A van der Heide; Antonetta C Houweling; Greetje Groenendaal; Regina G H Beets-Tan; Philippe Lambin Journal: Magn Reson Imaging Date: 2012-07-06 Impact factor: 2.546
Authors: Jérémie Calais; Bernard Dubray; Lamyaa Nkhali; Sebastien Thureau; Charles Lemarignier; Romain Modzelewski; Isabelle Gardin; Frederic Di Fiore; Pierre Michel; Pierre Vera Journal: Eur J Nucl Med Mol Imaging Date: 2015-02-14 Impact factor: 9.236
Authors: Elizabeth A Kidd; Maria Thomas; Barry A Siegel; Farrokh Dehdashti; Perry W Grigsby Journal: Int J Radiat Oncol Biol Phys Date: 2012-04-18 Impact factor: 7.038
Authors: James M Wilson; Somnath Mukherjee; Kwun-Ye Chu; Thomas B Brunner; Mike Partridge; Maria Hawkins Journal: Radiat Oncol Date: 2014-06-24 Impact factor: 3.481