Lokal fortgeschrittenes mit neoadjuvanter Radiochemotherapie behandeltes Rektumkarzinom (LFRK): Histopathologische Korrelation von diffusionsgewichteter Magnetresonanztomographie und multiparametrischer PET/CT [Response of locally advanced rectal cancer (LARC) to radiochemotherapy: DW-MRI and multiparametric PET/CT in correlation with histopathology]

Details

Serval ID
serval:BIB_0D0ED8F838FD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Lokal fortgeschrittenes mit neoadjuvanter Radiochemotherapie behandeltes Rektumkarzinom (LFRK): Histopathologische Korrelation von diffusionsgewichteter Magnetresonanztomographie und multiparametrischer PET/CT [Response of locally advanced rectal cancer (LARC) to radiochemotherapy: DW-MRI and multiparametric PET/CT in correlation with histopathology]
Journal
Nuklearmedizin. Nuclear medicine
Author(s)
Cerny M., Dunet V., Rebecchini C., Hahnloser D., Prior J., Sempoux C., Schmidt S.
ISSN
2567-6407 (Electronic)
ISSN-L
0029-5566
Publication state
Published
Issued date
02/2019
Peer-reviewed
Oui
Volume
58
Number
1
Pages
28-38
Language
english
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Abstract
To prospectively evaluate histological significance and predictive value of changes in apparent diffusion coefficient (ADC) and <sup>18</sup> F-FDG PET/CT parameters in locally advanced rectal cancer (LARC) after neoadjuvant radiochemotherapy (RCT).
Twenty-one patients with untreated LARC underwent pre-RCT and post-RCT <sup>18</sup> F-FDG PET/CT and diffusion-weighted magnetic resonance imaging (DW-MRI), followed by surgery. For both datasets, two readers measured the tumor SUVmax, SUVmean, MTV, TLG, ADCmin, ADCmean, and respective differences (∆SUVmax, ∆SUVmean, ∆MTV, ∆TLG, ∆ADCmin, ∆ADCmean) for the whole tumor. Tumor regression grade according to Mandard (TRGm), percentage of residual tumor cells and fibrosis were estimated by two pathologists in consensus. Relationship between parameters was assessed on stepwise multivariate regression analysis and ROC curve analysis to evaluate their performance and predict the treatment response.
Eighteen LARCs were analyzed. SUVmax and SUVmean decreased from 21.3 ± 8.9 to 9.3 ± 5.5 g/mL, (p = 0.0002) and 12.3 ± 5.1 to 5.4 ± 3.1 g/mL, (p = 0.0002), respectively, after RCT, whereas ADCmin and ADCmean increased from 396 ± 269 to 573 ± 313×10 <sup>-6 </sup> mm <sup>2</sup> /s (p = 0.014) and 1159 ± 212 to 1355 ± 194×10 <sup>-6 </sup> mm <sup>2</sup> /s (p = 0.0008), respectively. TRGm and percentage of residual tumor cells independently correlated with post-RCT SUVmean (β = 0.73 and β = 0.76, p < 0.001) and post-RCT SUVmax (β = 0.72 and β = 0.78, p < 0.001), whereas percentage of fibrosis independently correlated with ∆ADCmean (β = 0.38, p = 0.008). Post-RCT, SUVmax and SUVmean performed well in predicting TRGm < 3 and residual tumor cells ≤ 20 %. ΔADCmean predicted fibrosis > 70 % well.
Post-RCT SUVmean, SUVmax and ∆ADCmean are complementary parameters for respectively evaluating residual tumor burden and amount of fibrosis in LARC. However, only SUV independently correlated with TRGm.
Keywords
Aged, Aged, 80 and over, Chemoradiotherapy, Diffusion Magnetic Resonance Imaging, Female, Humans, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Predictive Value of Tests, Rectal Neoplasms/diagnostic imaging, Rectal Neoplasms/pathology, Rectal Neoplasms/therapy, Treatment Outcome
Pubmed
Web of science
Create date
11/03/2019 18:31
Last modification date
20/08/2019 13:34
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