SUVmax-based Parameters of FDG-PET/CT Reliably Predict Pathologic Complete Response After Preoperative Hyperthermo-chemoradiotherapy in Rectal Cancer

Anticancer Res. 2018 Oct;38(10):5909-5916. doi: 10.21873/anticanres.12935.

Abstract

Background/aim: To determine the most reliable predictor for pathologic complete response (pCR) in patients who underwent preoperative chemoradiotherapy and regional hyperthermia (HCRT) for rectal cancer.

Patients and methods: Thirty-six patients were enrolled. The local control status of the patients was assessed using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), magnetic resonance imaging (MRI), and colonoscopy before and after HCRT. The relationships between various parameters of these clinical examinations and pCR were analyzed.

Results: Ten (28%) patients achieved pCR. The accuracies of predicting pCR using FDG-PET/CT, MRI, and colonoscopy were 78%, 61%, and 75%, respectively. FDG-PET/CT was the only independent predictive modality for pCR (p=0.021). The maximum standardized uptake value (SUVmax) and SUVmax normalized to liver uptake (SLR) after HCRT showed the highest sensitivity (90%) and the decreasing rate of SUVmax and SLR demonstrated the highest specificity (89%) for pCR.

Conclusion: SUVmax-based parameters of FDG-PET/CT after HCRT were the most reliable predictors for pCR.

Keywords: FDG-PET/CT; Rectal cancer; chemoradiotherapy; hyperthermia; pathologic complete response.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chemoradiotherapy*
  • Combined Modality Therapy
  • Female
  • Fluorodeoxyglucose F18 / metabolism*
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods*
  • Preoperative Care*
  • ROC Curve
  • Radiopharmaceuticals / metabolism
  • Rectal Neoplasms / diagnostic imaging
  • Rectal Neoplasms / metabolism
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / therapy
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18