Diagnostic performance of 18F-FDG PET/CT using point spread function reconstruction on initial staging of rectal cancer: a comparison study with conventional PET/CT and pelvic MRI.
Cancer Imaging
; 18(1): 4, 2018 Jan 30.
Article
en En
| MEDLINE
| ID: mdl-29378659
ABSTRACT
BACKGROUND:
Accurate staging is crucial for treatment selection and prognosis prediction in patients with rectal cancer. Point spread function (PSF) reconstruction can improve spatial resolution and signal-to-noise ratio of PET imaging. The aim of this study was to evaluate the effectiveness of 18F-FDG PET/CT with PSF reconstruction for initial staging in rectal cancer compared with conventional PET/CT and pelvic MRI.METHODS:
A total of 59 patients with rectal cancer underwent preoperative 18F-FDG PET/CT and pelvic MRI. The maximum standardized uptake value (SUVmax) and lesion to background (L/B) ratio of possible metastatic lymph nodes, and metabolic tumor volumes (MTVs) of primary tumors were calculated. For N and T (T1-2 vs T3-4) staging, sensitivities, specificities, positive predictive values, negative predictive values, and accuracies were compared between conventional PET/CT [reconstructed with ordered subset expectation maximization (OSEM)], PSF-PET/CT (reconstructed with OSEM+PSF), and pelvic MRI. Histopathologic analysis was the reference standard.RESULTS:
For N staging, PSF-PET/CT provided higher sensitivity (78.6%) than conventional PET/CT (64.3%), and pelvic MRI (57.1%), and all techniques showed high specificity (PSF-PET 95.4%, conventional PET 96.7%, pelvic MRI 93.5%). SUVmax and L/B ratio were significantly higher in PSF-PET/CT than conventional-PET/CT (p < 0.001). The accuracy for T staging in PSF-PET/CT (69.4%) was not significantly different to conventional PET/CT (73.5%) and pelvic MRI (73.5%). MTVs of PSF and conventional PET showed a significant difference among T stages (p < 0.001), with higher values in advanced stages. In M staging, both PSF and conventional PET/CT diagnosed all distant metastases correctly.CONCLUSIONS:
PSF-PET/CT produced images with higher lesion-to-background contrast than conventional PET/CT, which allowed improved detection of lymph node metastasis without compromising specificity, and showed comparable diagnostic value to MRI in local staging. PSF-PET/CT is likely to have a great value for initial staging in rectal cancer.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
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Procesamiento de Imagen Asistido por Computador
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Imagen por Resonancia Magnética
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Tomografía Computarizada por Tomografía de Emisión de Positrones
Tipo de estudio:
Diagnostic_studies
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Evaluation_studies
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Prognostic_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Cancer Imaging
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
Año:
2018
Tipo del documento:
Article
País de afiliación:
Japón