Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer

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Abstract

Purpose: The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). Methods: We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. Results: MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Conclusion: Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity for the prediction of neoadjuvant radiation chemotherapy response and recurrence in LARC.

Original languageEnglish
Pages (from-to)422-431
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume43
Issue number3
DOIs
StatePublished - 1 Mar 2016

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Fluorodeoxyglucose F18
Rectal Neoplasms
Disease-Free Survival
Radiation
Drug Therapy
Survival
Neoplasm Grading
Multivariate Analysis
Liver
Glycolysis
Positron Emission Tomography Computed Tomography
Logistic Models
Regression Analysis
Recurrence
Neoplasms

Keywords

  • F-Fluorodeoxyglucose
  • Metabolic volume
  • Positron-emission tomography
  • Prognostic parameter
  • Tumour heterogeneity
  • Tumour stage

Cite this

@article{31a722265f95456a9a3030f5998a9137,
title = "Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer",
abstract = "Purpose: The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). Methods: We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. Results: MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Conclusion: Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity for the prediction of neoadjuvant radiation chemotherapy response and recurrence in LARC.",
keywords = "F-Fluorodeoxyglucose, Metabolic volume, Positron-emission tomography, Prognostic parameter, Tumour heterogeneity, Tumour stage",
author = "Bang, {Ji In} and Seunggyun Ha and Kang, {Sung Bum} and Keun-Wook Lee and Lee, {Hye Seung} and Kim, {Jae Sung} and Oh, {Heung Kwon} and Ho-Young Lee and Kim, {Sang Eun}",
year = "2016",
month = "3",
day = "1",
doi = "10.1007/s00259-015-3180-9",
language = "English",
volume = "43",
pages = "422--431",
journal = "European Journal of Nuclear Medicine and Molecular Imaging",
issn = "1619-7070",
publisher = "Springer Verlag",
number = "3",

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TY - JOUR

T1 - Prediction of neoadjuvant radiation chemotherapy response and survival using pretreatment [18F]FDG PET/CT scans in locally advanced rectal cancer

AU - Bang, Ji In

AU - Ha, Seunggyun

AU - Kang, Sung Bum

AU - Lee, Keun-Wook

AU - Lee, Hye Seung

AU - Kim, Jae Sung

AU - Oh, Heung Kwon

AU - Lee, Ho-Young

AU - Kim, Sang Eun

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Purpose: The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). Methods: We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. Results: MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Conclusion: Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity for the prediction of neoadjuvant radiation chemotherapy response and recurrence in LARC.

AB - Purpose: The aim of this study was to investigate metabolic and textural parameters from pretreatment [18F]FDG PET/CT scans for the prediction of neoadjuvant radiation chemotherapy response and 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC). Methods: We performed a retrospective review of 74 patients diagnosed with LARC who were initially examined with [18F]FDG PET/CT, and who underwent neoadjuvant radiation chemotherapy followed by complete resection. The standardized uptake value (mean, peak, and maximum), metabolic volume (MV), and total lesion glycolysis of rectal cancer lesions were calculated using the isocontour method with various thresholds. Using three-dimensional textural analysis, about 50 textural features were calculated for PET images. Response to neoadjuvant radiation chemotherapy, as assessed by histological tumour regression grading (TRG) after surgery and 3-year DFS, was evaluated using univariate/multivariate binary logistic regression and univariate/multivariate Cox regression analyses. Results: MVs calculated using the thresholds mean standardized uptake value of the liver + two standard deviations (SDs), and mean standard uptake of the liver + three SDs were significantly associated with TRG. Textural parameters from histogram-based and co-occurrence analysis were significantly associated with TRG. However, multivariate analysis revealed that none of these parameters had any significance. On the other hand, MV calculated using various thresholds was significantly associated with 3-year DFS, and MV calculated using a higher threshold tended to be more strongly associated with 3-year DFS. In addition, textural parameters including kurtosis of the absolute gradient (GrKurtosis) were significantly associated with 3-year DFS. Multivariate analysis revealed that GrKurtosis could be a prognostic factor for 3-year DFS. Conclusion: Metabolic and textural parameters from initial [18F]FDG PET/CT scans could be indexes to assess tumour heterogeneity for the prediction of neoadjuvant radiation chemotherapy response and recurrence in LARC.

KW - F-Fluorodeoxyglucose

KW - Metabolic volume

KW - Positron-emission tomography

KW - Prognostic parameter

KW - Tumour heterogeneity

KW - Tumour stage

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U2 - 10.1007/s00259-015-3180-9

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AN - SCOPUS:84956655837

VL - 43

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JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

SN - 1619-7070

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ER -