BACKGROUND: The purpose of this study was to assess the value of magnetic resonance imaging (MRI) and additional (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced rectal cancer (LARC). METHODS: Data on 40 patients with LARC, who were treated with NAC and underwent MRI and FDG-PET/CT before and after NAC, were analyzed retrospectively. Surgery was performed at a median of 6 weeks after NAC and the images were compared with the histological findings. The tumor regression grade 3/4 was classified as a responder. RESULTS: Sixteen patients were pathological responders. Receiver operating characteristic (ROC) analysis revealed that MRI total volume after NAC (MRI-TV2) and ΔMRI-TV had the highest performance to assess responders (area under the ROC curve [AUC] 0.849 and AUC 0.853, respectively). The reduction rate of the maximum standardized uptake value (ΔSUVmax) was also an informative factor (AUC 0.719). There seems no added value of adding FDG-PET/CT to MRI-TV2 and ΔMRI-TV in assessment of NAC responders judging from changes in AUC (AUC of ΔSUVmax and MRI-TV2 was 0.844, and AUC of ΔSUVmax and ΔMRI-TV was 0.846). CONCLUSIONS: MRI-TV2 and ΔMRI-TV were the most accurate factors to assess pathological response to NAC. Although ΔSUVmax by itself was also informative, the addition of FDG-PET/CT to MRI did not improve performance. Patients with LARC who were treated by induction chemotherapy should receive an MRI examination before and after NAC to assess treatment response. A more than 70 % volume reduction shown by MRI volumetry may justify the omission of subsequent radiotherapy.
BACKGROUND: The purpose of this study was to assess the value of magnetic resonance imaging (MRI) and additional (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for tumor response to neoadjuvant chemotherapy (NAC) in patients with locally advanced rectal cancer (LARC). METHODS: Data on 40 patients with LARC, who were treated with NAC and underwent MRI and FDG-PET/CT before and after NAC, were analyzed retrospectively. Surgery was performed at a median of 6 weeks after NAC and the images were compared with the histological findings. The tumor regression grade 3/4 was classified as a responder. RESULTS: Sixteen patients were pathological responders. Receiver operating characteristic (ROC) analysis revealed that MRI total volume after NAC (MRI-TV2) and ΔMRI-TV had the highest performance to assess responders (area under the ROC curve [AUC] 0.849 and AUC 0.853, respectively). The reduction rate of the maximum standardized uptake value (ΔSUVmax) was also an informative factor (AUC 0.719). There seems no added value of adding FDG-PET/CT to MRI-TV2 and ΔMRI-TV in assessment of NAC responders judging from changes in AUC (AUC of ΔSUVmax and MRI-TV2 was 0.844, and AUC of ΔSUVmax and ΔMRI-TV was 0.846). CONCLUSIONS: MRI-TV2 and ΔMRI-TV were the most accurate factors to assess pathological response to NAC. Although ΔSUVmax by itself was also informative, the addition of FDG-PET/CT to MRI did not improve performance. Patients with LARC who were treated by induction chemotherapy should receive an MRI examination before and after NAC to assess treatment response. A more than 70 % volume reduction shown by MRI volumetry may justify the omission of subsequent radiotherapy.
Authors: Marc J Gollub; Ivana Blazic; David D B Bates; Naomi Campbell; Andrea Knezevic; Mithat Gonen; Patricio Lynn; Martin R Weiser; Julio Garcia-Aguilar; Andreas M Hötker; Andrea Cercek; Leonard Saltz Journal: Eur Radiol Date: 2018-10-02 Impact factor: 5.315
Authors: Stephan B Dreyer; Arfon G M T Powell; Stephen T McSorley; Ashita Waterston; James J Going; Joanne Edwards; Donald C McMillan; Paul G Horgan Journal: Ann Surg Oncol Date: 2016-11-21 Impact factor: 5.344
Authors: Antonella Petrillo; Roberta Fusco; Mario Petrillo; Vincenza Granata; Paolo Delrio; Francesco Bianco; Biagio Pecori; Gerardo Botti; Fabiana Tatangelo; Corradina Caracò; Luigi Aloj; Antonio Avallone; Secondo Lastoria Journal: Oncotarget Date: 2017-01-31
Authors: Gyu Sang Yoo; Hee Chul Park; Jeong Il Yu; Doo Ho Choi; Won Kyung Cho; Young Suk Park; Joon Oh Park; Ho Yeong Lim; Won Ki Kang; Woo Yong Lee; Hee Cheol Kim; Seong Hyeon Yun; Yong Beom Cho; Yoon Ah Park; Kyoung Doo Song; Seok-Hyung Kim; Sang Yun Ha Journal: Cancer Res Treat Date: 2019-09-25 Impact factor: 4.679