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PET/CT and Histopathologic Response to Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

The objective of this study was to investigate the possibility of using positron emission tomography/computer tomography to predict the histopathologic response in locally advanced rectal cancer treated with preoperative chemoradiation.

Methods

The study included 30 patients with locally advanced rectal adenocarcinoma treated with a combination of radiotherapy and concurrent Uftoral® (uracil, tegafur) and leucovorine. All patients were evaluated by positron emission tomography/computer tomography scan seven weeks after end of chemoradiation, and the results were compared to histopathologic tumor regression as the “standard.” The pathologic response was quantified by tumor regression grade.

Results

Positron emission tomography/computer tomography correctly identified six of eight patients (specificity 75 percent) with complete pathologic response. However, the sensitivity of positron emission tomography/computer tomography was only 45 percent and the accuracy 53 percent. The positive and negative predictive values were 83 and 33 percent, respectively.

Conclusions

We conclude that positron emission tomography/computer tomography performed seven weeks after the end of chemoradiation is not able to predict the histopathologic response in locally advanced rectal cancer. There is an obvious need for other complementary methods especially with respect to the low sensitivity of positron emission tomography/computer tomography.

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Authors and Affiliations

  1. Danish Colorectal Cancer Group South, Vejle Hospital, Kabbeltoft 25, Vejle, Denmark

    Charlotte Kristiansen M.D., Jan Lindebjerg M.D., Claus Bisgaard M.D. & Anders Jakobsen M.D., D.M.Sc.

  2. PET and Cyclotron Unit, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

    Annika Loft M.D., Ph.D., Anne K. Berthelsen M.D. & Jesper Graff M.D., Ph.D., D.M.Sc.

  3. Department of Oncology, Vejle Hospital, Kabbeltoft 25, DK-7100, Vejle, Denmark

    Charlotte Kristiansen M.D. & Anders Jakobsen M.D., D.M.Sc.

Authors
  1. Charlotte Kristiansen M.D.
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  2. Annika Loft M.D., Ph.D.
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  3. Anne K. Berthelsen M.D.
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  4. Jesper Graff M.D., Ph.D., D.M.Sc.
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  5. Jan Lindebjerg M.D.
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  6. Claus Bisgaard M.D.
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  7. Anders Jakobsen M.D., D.M.Sc.
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Corresponding author

Correspondence to Charlotte Kristiansen M.D..

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Kristiansen, C., Loft, A., Berthelsen, A.K. et al. PET/CT and Histopathologic Response to Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer. Dis Colon Rectum 51, 21–25 (2008). https://doi.org/10.1007/s10350-007-9095-1

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  • DOI: https://doi.org/10.1007/s10350-007-9095-1

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