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Comparison of CT, MRI and FDG-PET in response prediction of patients with locally advanced rectal cancer after multimodal preoperative therapy: Is there a benefit in using functional imaging?

  • Gastrointestinal
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Abstract

The aim of this study was to compare CT, MRI and FDG-PET in the prediction of outcome of neoadjuvant radiochemotherapy in patients with locally advanced primary rectal cancer. A total of 23 patients with T3/4 rectal cancer underwent a preoperative radiochemotherapy combined with regional hyperthermia. Staging was performed using four-slice CT (n=23), 1.5-T MRI (n=10), and 18F-FDG-PET (n=23) before and 2–4 weeks after completion of neoadjuvant treatment. Response criteria were a change in T category and tumour volume for CT and MRI and a change in glucose uptake (standard uptake value) within the tumour for FDG-PET. Imaging results were compared with those of pretherapy endorectal ultrasound and histopathological findings. Histopathology showed a response to neoadjuvant therapy in 13 patients whereas 10 patients were classified as nonresponders. The mean SUV reduction in responders (60±14%) was significantly higher than in nonresponders (37±31%; P=0.030). The sensitivity and specificity of FDG-PET in identifying response was 100% (CT 54%, MRI 71%) and 60% (CT 80%, MRT 67%). Positive and negative predictive values were 77% (CT 78%, MRI 83%) and 100% (CT 57%, MRI 50%) (PET P=0.002, CT P=0.197, MRI P=0.500). These results suggest that FDG-PET is superior to CT and MRI in predicting response to preoperative multimodal treatment of locally advanced primary rectal cancer.

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Acknowledgement

This study was supported by the Deutsche Forschungsgemeinschaft as part of the project Graduiertenkolleg 331—Temperaturabhängige Effekte in Therapie und Diagnostik and the project SFB 273—Hyperthermia: Methodics and Clinics.

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  1. Klinik für Strahlenheilkunde und PET-Zentrum Berlin Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany

    T. Denecke, B. Rau, K.-T. Hoffmann, B. Hildebrandt, J. Ruf, M. Gutberlet, M. Hünerbein, R. Felix, P. Wust & H. Amthauer

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  1. T. Denecke
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  2. B. Rau
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  3. K.-T. Hoffmann
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  4. B. Hildebrandt
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  5. J. Ruf
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  6. M. Gutberlet
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  7. M. Hünerbein
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  8. R. Felix
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  9. P. Wust
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  10. H. Amthauer
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Correspondence to T. Denecke.

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Denecke, T., Rau, B., Hoffmann, KT. et al. Comparison of CT, MRI and FDG-PET in response prediction of patients with locally advanced rectal cancer after multimodal preoperative therapy: Is there a benefit in using functional imaging?. Eur Radiol 15, 1658–1666 (2005). https://doi.org/10.1007/s00330-005-2658-4

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  • DOI: https://doi.org/10.1007/s00330-005-2658-4

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