Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile.
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Petrillo, A., Fusco, R., Petrillo, M., Granata, V., Delrio, P., Bianco, F., Pecori, B., et al. (2017). Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile.. Oncotarget, 8 (5), 8143-8153. https://doi.org/10.18632/oncotarget.14106
PURPOSE: To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS: 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS). 18F-FDG PET/CT analysis was performed using SUV maximum (SUVmax). Tumor regression grade (TRG) were estimated after surgery. Non-parametric tests, receiver operating characteristic were evaluated. RESULTS: 55 patients (TRG1-2) were classified as responders while 20 subjects as non responders. ΔSIS reached sensitivity of 93%, specificity of 80% and accuracy of 89% (cut-off 6%) to differentiate responders by non responders, sensitivity of 93%, specificity of 69% and accuracy of 79% (cut-off 30%) to identify pathological complete response (pCR). Therapy assessment via ΔSUVmax reached sensitivity of 67%, specificity of 75% and accuracy of 70% (cut-off 60%) to differentiate responders by non responders and sensitivity of 80%, specificity of 31% and accuracy of 51% (cut-off 44%) to identify pCR. CONCLUSIONS: CRT response assessment by DCE-MRI analysis shows a higher predictive ability than 18F-FDG PET/CT in LARC patients allowing to better discriminate significant and pCR.
Humans, Rectal Neoplasms, Siloxanes, Fluorodeoxyglucose F18, Contrast Media, Radiopharmaceuticals, Magnetic Resonance Imaging, Treatment Outcome, Neoadjuvant Therapy, Remission Induction, Digestive System Surgical Procedures, Area Under Curve, Reproducibility of Results, Predictive Value of Tests, ROC Curve, Regional Blood Flow, Adult, Aged, Middle Aged, Female, Male, Perfusion Imaging, Magnetite Nanoparticles, Chemoradiotherapy, Adjuvant, Positron Emission Tomography Computed Tomography
External DOI: https://doi.org/10.18632/oncotarget.14106
This record's URL: https://www.repository.cam.ac.uk/handle/1810/292312
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/
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