| Accurate prediction of pathological rectal tumor response after two weeks of preoperative radiochemotherapy using (18)F-fluorodeoxyglucose-positron emission tomography-computed tomography imaging. | |
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MedLine Citation:
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PMID: 19646825 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To determine the optimal time point for repeated (18)F-fluorodeoxyglucose-positron emission tomography (PET)-CT imaging during preoperative radiochemotherapy (RCT) and the best predictive factor for the prediction of pathological treatment response in patients with locally advanced rectal cancer. METHODS AND MATERIALS: A total of 30 patients referred for preoperative RCT treatment were included in this prospective study. All patients underwent sequential PET-CT imaging at four time points: prior to therapy, at day 8 and 15 during RCT, and shortly before surgery. Tumor metabolic treatment responses were correlated with the pathological responses by evaluation of the tumor regression grade (TRG) and the pathological TN (ypT) stage of the resected specimen. RESULTS: Based on their TRG evaluations, 13 patients were classified as pathological responders, whereas 17 patients were classified as pathological nonresponders. The response index (RI) for the maximum standardized uptake value (SUV(max)) on day 15 of RCT was found to be the best predictive factor for the pathological response (area under the curve [AUC] = 0.87) compared to the RI on day 8 (AUC = 0.78) or the RI of presurgical PET imaging (AUC = 0.66). A cutoff value of 43% for the reduction of SUV(max) resulted in a sensitivity of 77% and a specificity of 93%. CONCLUSIONS: The SUV(max)-based RI calculated after the first 2 weeks of RCT provided the best predictor of pathological treatment response, reaching AUCs of 0.87 and 0.84 for the TRG and the ypT stage, respectively. However, a few patients presented with peritumoral inflammatory reactions, which led to mispredictions. Exclusion of these patients further enhanced the predictive accuracy of PET imaging to AUCs of 0.97 and 0.89 for TRG and ypT, respectively. |
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Authors:
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Marco H M Janssen; Michel C Ollers; Robert G Riedl; J?rgen van den Bogaard; Jeroen Buijsen; Ruud G P M van Stiphout; Hugo J W L Aerts; Philippe Lambin; Guido Lammering |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-07-29 |
Journal Detail:
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Title: International journal of radiation oncology, biology, physics Volume: 77 ISSN: 1879-355X ISO Abbreviation: Int. J. Radiat. Oncol. Biol. Phys. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-11 Completed Date: 2010-05-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7603616 Medline TA: Int J Radiat Oncol Biol Phys Country: United States |
Other Details:
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Languages: eng Pagination: 392-9 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Radiation Oncology (MAASTRO), GROW Research Institute, University Medical Centre Maastricht, Maastricht, The Netherlands. marco.janssen@maastro.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Area Under Curve Fluorodeoxyglucose F18 / diagnostic use*, pharmacokinetics Humans Positron-Emission Tomography / methods* Prospective Studies ROC Curve Radiopharmaceuticals / diagnostic use*, pharmacokinetics Rectal Neoplasms / drug therapy, metabolism, pathology, radionuclide imaging*, radiotherapy Remission Induction Statistics, Nonparametric Time Factors Tomography, X-Ray Computed / methods* Tumor Burden |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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