(18)F-FDG PET bio-metabolic monitoring of neoadjuvant therapy effects in rectal cancer: focus on nodal disease characteristics.
Radiother Oncol
; 97(2): 212-6, 2010 Nov.
Article
en En
| MEDLINE
| ID: mdl-20970865
ABSTRACT
OBJECTIVE:
To evaluate efficacy of (18)F-FDG PET(CT) in the staging and re staging of patients with locally advanced rectal cancer, its potential role in predicting pathological response to neoadjuvant therapy. PATIENTS ANDMETHODS:
Patients with confirmed diagnosis of rectal cancer (T2-4 or N+) were prospectively studied with (18)F-FDG PET before and after neoadjuvant therapy. Surgery was programmed 4-6 weeks after treatment followed by an expert histological analysis of the surgical specimen. Response to neoadjuvant treatment was assessed using two specific variables difference in SUV (difSUV) pre/post-neoadjuvant treatment and response index (RI).RESULTS:
A total of 64 patients were enrolled for pathological and bio-metabolic response assessment. Compared to cN0, cN+ patients had a higher SUV(1) mean value (6.5 vs. 7.6, p=0.04) and ypN+ patients had higher SUV(2) mean values (2.4 vs 3.5, p=0.06). difSUV values of ≥4 was the most efficient diagnostic parameter (sensitivity=45.8%, specificity=86.2%, positive predictive value (PPV)=73.3%, negative predictive value(NPV)=65.7%). With an RI of 66.6%, the sensitivity was 38.5%, specificity=81.5%, PPV=66.6%, and NPV=57.8%. Patients who experienced disease progression had an RI≤66% and a difSUV≤4.CONCLUSION:
(18)F-FDG PET has proven to be an accurate diagnostic technique for assessing rectal cancer response to neoadjuvant therapy. The results in terms of sensitivity, specificity, PPV and NPV were similar, if not superior, to those reported with other diagnostic imaging techniques.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
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Fluorodesoxiglucosa F18
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Terapia Neoadyuvante
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Tomografía de Emisión de Positrones
Tipo de estudio:
Prognostic_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Radiother Oncol
Año:
2010
Tipo del documento:
Article
País de afiliación:
España