Journal ArticleDOI
Comparison of 18 F-FDG PET/CT methods of analysis for predicting response to neoadjuvant chemoradiation therapy in patients with locally advanced low rectal cancer
Corinna Altini,Artor Niccoli Asabella,Raffaele De Luca,Margherita Fanelli,Cosimo Caliandro,Natale Quartuccio,Domenico Rubini,Angelina Cistaro,Severino Montemurro,Giuseppe Rubini +9 more
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TLDR
Qualitative and semiquantitative evaluations for 18F-FDG PET/CT evaluations for LARC are the optimal approach; a valid parameter for response prediction has still to be established.Abstract:
The aim of this study was to prospectively investigate the predictive value of 18F-FDG PET/CT semiquantitative parameters for locally advanced low rectal cancer (LARC) treated by neoadjuvant chemoradiation therapy (nCRT). 68 patients with LARC had 18F-FDG PET/CT scans twice (baseline and 5–6 weeks post-nCRT). All patients underwent surgery with preservation of the sphincter 8 weeks later. 18F-FDG PET/CT analysis was performed by visual response assessment (VRA) and semiquantitative parameters: SUVmaxbaseline, SUVmeanbaseline, MTVbaseline, TLGbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, TLGpost-nCRT; ΔSUVmax and mean and Response indexes (RImax% and RImean%). Assessment of nCRT tumor response was performed according to the Mandard’s Tumor Regression Grade (TRG) and (y)pTNM staging on the surgical specimens. Concordances of VRA with TRG, and with (y)pTNM criteria were evaluated by Cohen’s K. Results were compared by t student test for unpaired groups. ROC curve analysis was performed. VRA analysis of post-nCRT 18F-FDG PET/CT scan for the (y)pTNM outcome showed sensitivity, specificity, accuracy, PPV, and NPV of 87.5%, 66.7%, 83.8%, 92.5%, and 53.3%, respectively. Concordances of VRA with TRG and with (y)pTNM were moderate. For the outcome variable TRG, the statistical difference between responders and non-responders was significant for SUVmaxpost-nCRT and RImean%; for the outcome variable (y)pTNM, there was a significant difference for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. ROC analysis showed better AUCs: for the outcome variable TRG for SUVmaxpost-nCRT, SUVmeanpost-nCRT, and RImean%; for the outcome variable (y)pTNM for MTVbaseline, SUVmaxpost-nCRT, SUVmeanpost-nCRT, MTVpost-nCRT, RImax%, and RImean%. No significant differences among parameters were found. Qualitative and semiquantitative evaluations for 18F-FDG PET/CT are the optimal approach; a valid parameter for response prediction has still to be established.read more
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Journal ArticleDOI
Neoadjuvant Rectal (NAR) Score: a New Surrogate Endpoint in Rectal Cancer Clinical Trials.
TL;DR: The neoadjuvant rectal (NAR) score offers an opportunity to incorporate a novel surrogate endpoint into early phase rectal cancer clinical trials, based upon variables routinely collected and available to clinical investigators during the conduct of prospective studies.
Journal ArticleDOI
18F-FDG PET/CT role in staging of gastric carcinomas: comparison with conventional contrast enhancement computed tomography.
Corinna Altini,Artor Niccoli Asabella,Alessandra Di Palo,Margherita Fanelli,Cristina Ferrari,Marco Moschetta,Giuseppe Rubini +6 more
TL;DR: The 18F-FDG PET/CT is a useful tool for the evaluation of gastric carcinoma to detect primary lesion, lymphnode, and distant metastases using 1 single image whole-body technique.
Journal ArticleDOI
Magnetic Resonance Imaging evaluation in neoadjuvant therapy of Locally Advanced Rectal Cancer: a systematic review
Roberta Fusco,Mario Petrillo,Vincenza Granata,Salvatore Filice,Mario Sansone,Orlando Catalano,Antonella Petrillo +6 more
TL;DR: Morphological MRI is the modality of choice for rectal cancer staging permitting a correct assessment of the disease extent, of the lymph node involvement, ofThe mesorectal fascia and of the sphincter complex for surgical planning.
Journal ArticleDOI
Volumetric parameters changes of sequential 18F-FDG PET/CT for early prediction of recurrence and death in patients with locally advanced rectal cancer treated with preoperative chemoradiotherapy.
Seong-Jang Kim,Samuel Chang +1 more
TL;DR: The data suggest that MTV on initial pretreatment 18F-FDG PET/CT and &Dgr;TLG after preoperative concurrent chemoradiotherapy in LARC patients could provide prognostic information and were the potent predictors for RFS and OS.
Journal ArticleDOI
The use of PET/MRI for imaging rectal cancer
TL;DR: Overall PET/MRI can improve the staging of rectal cancer, although this potential has yet to be fulfilled.
References
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Journal ArticleDOI
From RECIST to PERCIST: Evolving Considerations for PET Response Criteria in Solid Tumors
TL;DR: Qualitative and quantitative approaches to 18F-FDG PET response assessment have been applied and require a consistent PET methodology to allow quantitative assessments and the proposed PERCIST 1.0 criteria should serve as a starting point for use in clinical trials and in structured quantitative clinical reporting.
Journal ArticleDOI
Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations.
Anne-Marie Mandard,Frédéric Dalibard,Jean-Claude Mandard,Jacques Marnay,Michel Henry-Amar,Jean-François Petiot,Alain Roussel,Jacques-Henry Jacob,Philippe Segol,Guy Samama,Jean-Marie Ollivier,Sylvie Bonvalot,M. Gignoux +12 more
TL;DR: A pilot study was undertaken to determine if pathologic assessment of tumor regression correlated with disease free survival in patients with esophageal carcinoma.
Journal ArticleDOI
Clinical practice guidelines in oncology
William J. Gradishar,Benjamin O. Anderson,Ron Balassanian,Sarah L. Blair,Harold J. Burstein,Amy E. Cyr,Anthony D. Elias,William B. Farrar,Andres Forero,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Janice A. Lyons,P. Kelly Marcom,Ingrid A. Mayer,Beryl McCormick,Meena S. Moran,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Elizabeth C. Reed,Kilian E. Salerno,Lee S. Schwartzberg,Amy Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,George Somlo,Melinda L. Telli,John H. Ward,Rashmi Kumar,Dorothy A. Shead +32 more
TL;DR: This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
Journal ArticleDOI
Operative versus nonoperative treatment for stage 0 distal rectal cancer following chemoradiation therapy: long-term results.
Angelita Habr-Gama,Rodrigo Oliva Perez,Wladimir Nadalin,Jorge Sabbaga,Ulysses Ribeiro,Afonso Henrique da Silva e Sousa,Fábio Campos,Desidério Roberto Kiss,Joaquim Gama-Rodrigues +8 more
TL;DR: Stage 0 rectal cancer disease is associated with excellent long-term results irrespective of treatment strategy and Surgical resection may not lead to improved outcome in this situation and may be associated with high rates of temporary or definitive stoma construction and unnecessary morbidity and mortality rates.
Journal ArticleDOI
Prognostic Significance of Tumor Regression After Preoperative Chemoradiotherapy for Rectal Cancer
Claus Rödel,Peter Martus,Thomas Papadoupolos,László Füzesi,Martin Klimpfinger,Rainer Fietkau,Torsten Liersch,Werner Hohenberger,Rudolf Raab,Rolf Sauer,Christian Wittekind +10 more
TL;DR: In this exploratory analysis, complete ( TRG 4) and intermediate pathologic response (TRG 2 + 3) suggested improved DFS after preoperative CRT, and TRG assessment should be implemented in pathologic evaluation and prospectively validated in further studies.
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