Soni Abhishek, Chandola Stuti, Das Chandan Jyoti, Sharma Raju, Pathy Sushmita, Bhattacharjee Hemanaga Kumar, Chandrashekhara Sheragaru Hanumanthappa, Sharma Atul, Kumar Rakesh
Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Radiation Oncology, BRAIRCH, All India Institute of Medical Sciences, New Delhi, India.
Indian J Nucl Med. 2024 Jul-Aug;39(4):279-285. doi: 10.4103/ijnm.ijnm_60_24. Epub 2024 Nov 18.
The objective is to evaluate the efficacy of F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) computed tomography (CT) in the evaluation of tumor response to preoperative/palliative chemoradiotherapy (CRT) for advanced colorectal cancer; including metastatic cancer at primary presentation and recurrent cancers with local and/or distant metastasis.
Fifty patients with advanced rectal cancer underwent two point imaging with 18 FDG PET-CT before and after 3 weeks of completion of preoperative/palliative CRT in between 2016 and 2022. Patients with locally recurrent cancer also underwent radical surgery. The assessment consisted of the evaluation of the following metabolic PET parameters: Maximum standardized uptake value (SUV), SUV, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Response was assessed among the followed patients using RECIST 1.1 criteria.
There was a significant decline in the mean post therapy SUV and SUV as compared to baseline ( = 0.0001). Twenty-six out of 50 (52%) patients were classified as responders. A significant decrease in all parameters (SUV, SUV, TLG, and MTV) from baseline was observed in responders of the study when comparing with nonresponders ( < 0.05). Besides SUV and SUV, the mean posttherapy TLG was significantly reduced in responders than nonresponders ( = 0.0065).
PET-CT is a useful combined anatomic and functional imaging modality in monitoring tumor response to preoperative/palliative CRT in advanced rectal cancer, whether primary or recurrent, including metastatic cancers at presentation. Posttherapy SUV and TLG in particular are significantly associated with treatment response.
评估氟脱氧葡萄糖正电子发射断层扫描（F-FDG-PET）计算机断层扫描（CT）在评估晚期结直肠癌术前/姑息性放化疗（CRT）后肿瘤反应中的疗效；包括初诊时伴有转移癌以及局部和/或远处转移的复发性癌症。
2016年至2022年间，50例晚期直肠癌患者在术前/姑息性CRT完成3周前后接受了18 FDG PET-CT双点成像。局部复发性癌症患者也接受了根治性手术。评估包括对以下代谢PET参数的评估：最大标准化摄取值（SUV）、SUV、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）。使用RECIST 1.1标准对随访患者的反应进行评估。
与基线相比，治疗后平均SUV和SUV显著下降（=0.0001）。50例患者中有26例（52%）被分类为反应者。与无反应者相比，该研究的反应者中所有参数（SUV、SUV、TLG和MTV）从基线均显著降低（<0.05）。除SUV和SUV外，反应者的治疗后平均TLG比无反应者显著降低（=0.0065）。
PET-CT是一种有用的解剖学和功能成像相结合的方式，可用于监测晚期直肠癌（无论是原发性还是复发性，包括初诊时的转移性癌症）术前/姑息性CRT后的肿瘤反应。特别是治疗后的SUV和TLG与治疗反应显著相关。
