Publication:
The value of metabolic imaging to predict tumour response after chemoradiation in locally advanced rectal cancer

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2010-12-15

Authors

Palma, Pablo
Conde-Muíño, Raquel
Rodríguez-Fernández, Antonio
Segura-Jiménez, Inmaculada
Sánchez-Sánchez, Rocío
Martín-Cano, Javier
Gómez-Río, Manuel
Ferrón, José A
Llamas-Elvira, José M

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BioMed Central
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Abstract

Background: We aim to investigate the possibility of using 18F-positron emission tomography/computer tomography (PET-CT) to predict the histopathologic response in locally advanced rectal cancer (LARC) treated with preoperative chemoradiation (CRT). Methods: The study included 50 patients with LARC treated with preoperative CRT. All patients were evaluated by PET-CT before and after CRT, and results were compared to histopathologic response quantified by tumour regression grade (patients with TRG 1-2 being defined as responders and patients with grade 3-5 as non-responders). Furthermore, the predictive value of metabolic imaging for pathologic complete response (ypCR) was investigated. Results: Responders and non-responders showed statistically significant differences according to Mandard's criteria for maximum standardized uptake value (SUVmax) before and after CRT with a specificity of 76,6% and a positive predictive value of 66,7%. Furthermore, SUVmax values after CRT were able to differentiate patients with ypCR with a sensitivity of 63% and a specificity of 74,4% (positive predictive value 41,2% and negative predictive value 87,9%); This rather low sensitivity and specificity determined that PET-CT was only able to distinguish 7 cases of ypCR from a total of 11 patients. Conclusions: We conclude that 18-F PET-CT performed five to seven weeks after the end of CRT can visualise functional tumour response in LARC. In contrast, metabolic imaging with 18-F PET-CT is not able to predict patients with ypCR accurately

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Preliminary data of this work were presented by RCM and awarded at the 2009 Annual Meeting of the Spanish Society of Coloproctology (AECP) held in Barcelona.

MeSH Terms

Medical Subject Headings::Named Groups::Persons::Age Groups::Adult
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged::Aged, 80 and over
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Chemotherapy, Adjuvant
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Combined Modality Therapy
Medical Subject Headings::Chemicals and Drugs::Carbohydrates::Deoxy Sugars::Deoxyglucose::Fluorodeoxyglucose F18
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Tomography, Emission-Computed::Positron-Emission Tomography
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Sensitivity and Specificity::Predictive Value of Tests
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Gastrointestinal Neoplasms::Intestinal Neoplasms::Colorectal Neoplasms::Rectal Neoplasms
Medical Subject Headings::Check Tags::Female

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Keywords

Adulto, Anciano, Anciano de 80 o más Años, Carcinoma, Quimioterapia, Terapia Combinada, Femenino, Fluorodesoxiglucosa F18, Humanos, Masculino, Mediana Edad, Tomografía de Emisión de Positrones, Valor Predictivo de las Pruebas, Pronóstico, Neoplasias del Recto, Sensibilidad y Especificidad

Citation

Palma P, Conde-Muíño R, Rodríguez-Fernández A, Segura-Jiménez I, Sánchez-Sánchez R, Martín-Cano J, et al. The value of metabolic imaging to predict tumour response after chemoradiation in locally advanced rectal cancer. Radiat Oncol. 2010 Dec 15;5:119