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01-12-2009

Accuracy of MRI and ¹⁸F-FDG PET/CT for Restaging After Preoperative Concurrent Chemoradiotherapy for Rectal Cancer

Authors: Yong Beom Cho, Ho-Kyung Chun, Min Ju Kim, Joon Young Choi, Chi-Min Park, Byung-Tae Kim, Soon Jin Lee, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee

Published in: World Journal of Surgery | Issue 12/2009

Abstract

Background

Performing a restaging work-up with magnetic resonance imaging (MRI) and ¹⁸F-fluorodeoxyglucose-positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) can provide information about the effects that are related to preoperative concurrent chemoradiotherapy (CCRT). The purpose of the present study was to investigate the accuracy of MRI and ¹⁸F-FDG PET/CT for restaging after preoperative CCRT for rectal cancer.

Methods

Between April 2005 and February 2006, 30 patients with histologically proven rectal adenocarcinoma were included in this study. Pelvic MRI and ¹⁸F-FDG PET/CT were performed to clinically restage the tumor after CCRT. The results of the pathologic staging were correlated with those of the MRI and ¹⁸F-FDG PET/CT after CCRT. Two patients underwent transanal endoscopic microsurgery after CCRT, and they were excluded when the N category was evaluated.

Results

The overall accuracy of MRI for the T category was 67% (κ = 0.422, P = 0.003), whereas overstaging and understaging occurred in 30 and 3% of the patients, respectively. For the N category, accurate staging was noted in 75% (κ = 0.410, P = 0.030) of all the patients, whereas 14% were overstaged and 11% were understaged. The overall accuracy rates for the T and N categories with performing ¹⁸F-FDG PET/CT were 60% (κ = 0.372, P = 0.004) and 71% (κ = 0.097, P = 0.549), respectively. While MRI could not predict any patient who showed a pathologic complete response, ¹⁸F-FDG PET/CT predicted three of the four patients who showed a pathologic complete response after preoperative CCRT. Furthermore, ¹⁸F-FDG PET/CT identified distant metastases with an accuracy rate of 97%.

Conclusions

For restaging patients with rectal cancer after preoperative CCRT, MRI is a useful diagnostic modality to predict both the T and N categories. ¹⁸F-FDG PET/CT is helpful in predicting a pathologic complete response and in finding metastasis after preoperative CCRT.

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Title: Accuracy of MRI and 18F-FDG PET/CT for Restaging After Preoperative Concurrent Chemoradiotherapy for Rectal Cancer
Authors: Yong Beom Cho
Ho-Kyung Chun
Min Ju Kim
Joon Young Choi
Chi-Min Park
Byung-Tae Kim
Soon Jin Lee
Seong Hyeon Yun
Hee Cheol Kim
Woo Yong Lee
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 12/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-0248-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accuracy of MRI and ¹⁸F-FDG PET/CT for Restaging After Preoperative Concurrent Chemoradiotherapy for Rectal Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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