FDG-PET parameters predict for recurrence in anal cancer - results from a prospective, multicentre clinical trial.
Adult
Aged
Anus Neoplasms
/ pathology
Australia
/ epidemiology
Carcinoma, Squamous Cell
/ pathology
Chemoradiotherapy
/ methods
Female
Fluorodeoxyglucose F18
Humans
Incidence
Male
Middle Aged
Neoplasm Recurrence, Local
/ diagnosis
Positron-Emission Tomography
/ methods
Prognosis
Prospective Studies
Radiopharmaceuticals
Radiotherapy, Intensity-Modulated
/ methods
Anal cancer
Chemo-radiotherapy
Positron emission tomography
Journal
Radiation oncology (London, England)
ISSN: 1748-717X
Titre abrégé: Radiat Oncol
Pays: England
ID NLM: 101265111
Informations de publication
Date de publication:
06 Aug 2019
06 Aug 2019
Historique:
received:
15
05
2019
accepted:
18
07
2019
entrez:
8
8
2019
pubmed:
8
8
2019
medline:
8
2
2020
Statut:
epublish
Résumé
To investigate the prognostic significance of positron emission tomography (PET) parameters from F-18 fluorodeoxyglucose (FDG) PET scans performed pre- and post- chemo-radiotherapy (CRT) for squamous cell carcinoma of the anal canal (AC). From January 2013 to January 2017, 19 patients with non-metastatic AC enrolled on a prospective trial underwent FDG-PET/CT imaging before and 12 weeks following CRT. A computer-generated volume of interest (VOI) was snapped around the primary tumour using six different standard uptake value (SUV) thresholds and the following parameters were extracted: SUV max, mean, median, standard deviation and peak as well as metabolic tumour volume (MTV) and total lesion glycolysis. Exact logistic regression and ROC AUC analyses were performed for each metric at each timepoint. With a median follow up of 15.8 months, 3/19 patients had a local recurrence and 5/19 had any recurrence. On post-CRT PET, the median SUV within a VOI bounded by an SUV of 3 correlated with local recurrence (p < 0.01) and demonstrated excellent discrimination (ROC AUC 1.00, perfect separation was achieved at a median SUV of 3.38). The mean SUV at this threshold did not quite reach significance for prediction of local recurrence (p = 0.06) but demonstrated excellent discrimination (ROC AUC 0.91). The MTV bounded by a threshold of 41% SUVmax on the pre-CRT PET predicted for any recurrence (p = 0.03) and showed excellent discrimination (ROC AUC 0.89). FDG-PET parameters are predictive of recurrence in AC. FDG-PET may represent a valuable tool for prognostication and response assessment in AC. ANZCTR, ACTRN12614001219673 . Registered 19 November 2014 - Retrospectively registered.
Sections du résumé
BACKGROUND
BACKGROUND
To investigate the prognostic significance of positron emission tomography (PET) parameters from F-18 fluorodeoxyglucose (FDG) PET scans performed pre- and post- chemo-radiotherapy (CRT) for squamous cell carcinoma of the anal canal (AC).
METHODS
METHODS
From January 2013 to January 2017, 19 patients with non-metastatic AC enrolled on a prospective trial underwent FDG-PET/CT imaging before and 12 weeks following CRT. A computer-generated volume of interest (VOI) was snapped around the primary tumour using six different standard uptake value (SUV) thresholds and the following parameters were extracted: SUV max, mean, median, standard deviation and peak as well as metabolic tumour volume (MTV) and total lesion glycolysis. Exact logistic regression and ROC AUC analyses were performed for each metric at each timepoint.
RESULTS
RESULTS
With a median follow up of 15.8 months, 3/19 patients had a local recurrence and 5/19 had any recurrence. On post-CRT PET, the median SUV within a VOI bounded by an SUV of 3 correlated with local recurrence (p < 0.01) and demonstrated excellent discrimination (ROC AUC 1.00, perfect separation was achieved at a median SUV of 3.38). The mean SUV at this threshold did not quite reach significance for prediction of local recurrence (p = 0.06) but demonstrated excellent discrimination (ROC AUC 0.91). The MTV bounded by a threshold of 41% SUVmax on the pre-CRT PET predicted for any recurrence (p = 0.03) and showed excellent discrimination (ROC AUC 0.89).
CONCLUSIONS
CONCLUSIONS
FDG-PET parameters are predictive of recurrence in AC. FDG-PET may represent a valuable tool for prognostication and response assessment in AC.
TRIAL REGISTRATION
BACKGROUND
ANZCTR, ACTRN12614001219673 . Registered 19 November 2014 - Retrospectively registered.
Identifiants
pubmed: 31387597
doi: 10.1186/s13014-019-1342-9
pii: 10.1186/s13014-019-1342-9
pmc: PMC6685144
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
140Subventions
Organisme : The Royal Australian and New Zealand College of Radiologists
ID : 2014/RANZCR/006
Organisme : Hunter Translational Cancer Research Grant
ID : NA
Références
Radiother Oncol. 2001 Oct;61(1):15-22
pubmed: 11578724
Dis Colon Rectum. 2004 Jul;47(7):1136-44
pubmed: 15164245
Int J Radiat Oncol Biol Phys. 2008 May 1;71(1):180-6
pubmed: 17996387
Dis Colon Rectum. 2008 Feb;51(2):147-53
pubmed: 18180997
Radiother Oncol. 2008 Jun;87(3):376-82
pubmed: 18453023
Ann Surg Oncol. 2010 Jan;17(1):115-22
pubmed: 19826877
Radiother Oncol. 2010 Jun;95(3):288-91
pubmed: 20231040
Br J Cancer. 2011 Aug 9;105(4):498-504
pubmed: 21792197
Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):1455-62
pubmed: 22401917
Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):66-72
pubmed: 22592047
Radiology. 2012 Aug;264(2):559-66
pubmed: 22692034
J Nucl Med. 2012 Oct;53(10):1506-13
pubmed: 22895812
J Nucl Med. 2013 Jan;54(1):27-32
pubmed: 23236018
J Natl Cancer Inst. 2013 Feb 6;105(3):175-201
pubmed: 23297039
Eur J Nucl Med Mol Imaging. 2014 Jan;41(1):50-8
pubmed: 23948859
Nucl Med Mol Imaging. 2011 Mar;45(1):36-42
pubmed: 24899976
Radiother Oncol. 2014 Jun;111(3):330-9
pubmed: 24947004
Ann Surg Oncol. 2015 Oct;22(11):3574-81
pubmed: 25652048
BMC Cancer. 2015 Apr 14;15:281
pubmed: 25885556
Radiol Med. 2016 Jan;121(1):54-9
pubmed: 26126968
Pract Radiat Oncol. 2016 Sep-Oct;6(5):e149-e154
pubmed: 26948134
Eur J Radiol. 2016 Aug;85(8):1390-4
pubmed: 27423677
Eur J Nucl Med Mol Imaging. 2017 Jan;44(1):63-70
pubmed: 27503193
J Nucl Med. 2017 Sep;58(9):1414-1420
pubmed: 28280225
Contrast Media Mol Imaging. 2017 May 16;2017:5260305
pubmed: 29097926
Adv Radiat Oncol. 2017 Apr 29;2(3):281-287
pubmed: 29114593
Nucl Med Mol Imaging. 2018 Feb;52(1):5-15
pubmed: 29391907