Oncotarget

Research Papers:

Standardized Index of Shape (DCE-MRI) and Standardized Uptake Value (PET/CT): Two quantitative approaches to discriminate chemo-radiotherapy locally advanced rectal cancer responders under a functional profile

Antonella Petrillo _, Roberta Fusco, Mario Petrillo, Vincenza Granata, Paolo Delrio, Francesco Bianco, Biagio Pecori, Gerardo Botti, Fabiana Tatangelo, Corradina Caracò, Luigi Aloj, Antonio Avallone and Secondo Lastoria

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Oncotarget. 2017; 8:8143-8153. https://doi.org/10.18632/oncotarget.14106

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Abstract

Antonella Petrillo1, Roberta Fusco1, Mario Petrillo1, Vincenza Granata1, Paolo Delrio2, Francesco Bianco2, Biagio Pecori3, Gerardo Botti4, Fabiana Tatangelo5, Corradina Caracò6, Luigi Aloj6, Antonio Avallone7, Secondo Lastoria6

1Radiology Unit, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

2Gastrointestinal Surgical Oncology Unit, Department of Abdominal Oncology, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

3Radiotherapy Unit, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

4Scientific Director, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

5Diagnostic Pathology Unit, Department of Diagnostic and Laboratory Pathology “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

6Nuclear Medicine Unit, Department of Diagnostic Imaging, Radiant and Metabolic Therapy, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

7Gastrointestinal Medical Oncology Unit, Department of Abdominal Oncology, “Istituto Nazionale Tumori Fondazione Giovanni Pascale – IRCCS”, 80131, Naples, Italy

Correspondence to:

Antonella Petrillo, email: [email protected]

Keywords: rectal cancer, neoadjuvant chemo-radiotherapy, DCE-MRI and FDG-PET/CT, treatment response assessment

Received: August 26, 2016     Accepted: November 21, 2016     Published: December 22, 2016

ABSTRACT

Purpose: To investigate dynamic contrast enhanced-MRI (DCE-MRI) in the preoperative chemo-radiotherapy (CRT) assessment for locally advanced rectal cancer (LARC) compared to18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).

Methods: 75 consecutive patients with LARC were enrolled in a prospective study. DCE-MRI analysis was performed measuring SIS: linear combination of percentage change (Δ) of maximum signal difference (MSD) and wash-out slope (WOS). 18F-FDG PET/CT analysis was performed using SUV maximum (SUVmax). Tumor regression grade (TRG) were estimated after surgery. Non-parametric tests, receiver operating characteristic were evaluated.

Results: 55 patients (TRG1-2) were classified as responders while 20 subjects as non responders. ΔSIS reached sensitivity of 93%, specificity of 80% and accuracy of 89% (cut-off 6%) to differentiate responders by non responders, sensitivity of 93%, specificity of 69% and accuracy of 79% (cut-off 30%) to identify pathological complete response (pCR). Therapy assessment via ΔSUVmax reached sensitivity of 67%, specificity of 75% and accuracy of 70% (cut-off 60%) to differentiate responders by non responders and sensitivity of 80%, specificity of 31% and accuracy of 51% (cut-off 44%) to identify pCR.

Conclusions: CRT response assessment by DCE-MRI analysis shows a higher predictive ability than 18F-FDG PET/CT in LARC patients allowing to better discriminate significant and pCR.


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