RESUMO
OBJECTIVE: This study aimed to determine whether texture parameters could be used in differentiation between the tumor and the peritumoral tissues based on hybrid 18F-Fluorodeoxyglucose positron emission tomography/computed tomography imaging for patients with rectal cancer. METHODS: Seven parameters, including heterogeneity, entropy, energy, skewness, kurtosis, standard deviation, and average brightness, were extracted from positron emission tomography/computed tomography scans of 22 patients (12 male and 10 female; mean age, 61 ± 2 years). RESULTS: The peritumoral tissue had a significantly lower value of the heterogeneity parameter (23%) than the tumor. Tumor size (r = -0.48, P < 0.05) and extramural venous invasion scores (r = 0.64, P < 0.05) correlated with heterogeneity in the peritumoral tissue. There were significant differences (P < 0.05) in the correlation coefficients between men and women. CONCLUSIONS: Therefore, we provided additional quantitative information to differentiate the tumor from the peritumoral tissue and indicated possible application for extramural venous invasion evaluation in rectal cancer.
Assuntos
Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Compostos Radiofarmacêuticos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reto/diagnóstico por imagemRESUMO
INTRODUCTION: In recent years, the positron emission tomography combined with computed tomography (PET/CT) has changed and the treatment approaches in Hodgkins lymphoma (HL) patients have entirely improved. The main idea in several studies is the use of PET/CT and the International Prognostic Score (IPS) protocols in identification of patients within a high-risk group and potential early relapse/refractory disease. MATERIALS AND METHODS: This study was based on PET/CT evaluation and treatment strategies of patients from eight Centers of Hematology in Ukraine. The patients included were newly dia-gnosed with HL and were aged 67 years or younger. They received a treatment with ABVD or BEACOPP-14/esc or “switched-regimens” (ABVD + BEACOPP-esc/14, BEACOPP-esc/14 + ABVD). The primary endpoints were to assess a correlation between PET/CT findings at the time of dia-gnosis, response to the therapy and clinical outcome (relapse/death) for patients with early and advanced stages of HL. The secondary endpoints were to evaluate the relationship between IPS and PET/CT findings. RESULTS: The study group included 106 patients. The overall response rate (ORR) was 90.5%. The ORR for patients with stages I-II was 96.5% (55/57) vs. 91% (41/45) for stage III-IV patients. In total, the disease progression occurred in 58.3% (7/12) of PET2+ patients and in 13.3% (12/90) of PET2 patients (P < 0.05). No significant difference was found between the event free survival (EFS) rate and IPS for patients with PET2+ vs. PET2, (log-rank test; P = 0.4). The PET3 status was found in 88.8% (79/89) of the study group patients and 1.2% (10/89) had a PET3+ status (P < 0.05). Using the Cox regression, we confirmed a significant correlation between EFS with PET3 Deauville scale (DS) and IPS. Patients with DS 1-2, DS 3 and DS 4-5 had a 1-year event-free survival of 94.4%, 100% and 33%, respectively (HR 0.56; 95% CI 1.07-2.8; P < 0.02). Our multivariable analysis showed no statistically significant correlation between PET2+ and PET3+ status and extranodal involvement or large tumor burden. CONCLUSION: The results of using PET/CT in patients with primary HL demonstrated a high prognostic value of PET at the end of the treatment. In addition, we confirmed the predictive role of IPS prognostic model in the treatment outcome depending on PET status.