Please use this identifier to cite or link to this item:
http://hdl.handle.net/1843/55178
Type: | Artigo de Periódico |
Title: | Individualized threshold for tumor segmentation in 18F-FDG PET/CT imaging: the key for response evaluation of neoadjuvant chemoradiation therapy in patients with rectal cancer? |
Authors: | Theara C.fagundes Marcelo Mamede Arnoldo Mafra Rodrigo g. Silva Ana c. g. Castro Luciana c. Silva Priscilla t. Aguiar Josiane a. Silva Eduardo Paulino Júnior Alexei m. Machado |
Abstract: | Introduction: The standard treatment for locally advanced rectal cancer (RC) consists of neoadjuvant chemoradiation followed by radical surgery. Regardless the extensive use of SUV max in 18F-FDG PET tumor uptake as representation of tumor glycolytic consumption, there is a trend to apply metabolic volume instead. Thus, the aim of the present study was to evaluate a noninvasive method for tumor segmentation using the 18F-FDG PET imaging in order to predict response to neoadjuvant chemoradiation therapy in patients with rectal cancer. Method: The sample consisted of stage II and III rectal cancer patients undergoing 18F-FDG PET/CT examination before and eight weeks after neoadjuvant therapy. An individualized tumor segmentation methodology was applied to generate tumor volumes (SUV2SD) and compare with standard SUVmax and fixed threshold (SUV40%, SUV50% and SUV60%) pre- and post-therapy. Therapeutic response was assessed in the resected specimens using Dworak’s protocol recommendations. Several variables were generated and compared with the histopathological results. Results: Seventeen (17) patients were included and analyzed. Significant differences were observed between responders (Dworak 3 and 4) and non-responders for SUVmax-2 (p<0.01), SUV2SD-2 (p<0.05), SUV40%-2 (p<0.05), SUV50%-2 (p<0.05) and SUV60%-2 (p<0.05). ROC analyses showed significant areas under the curve (p<0.01) for the proposed methodology with sensitivity and specificity varying from 60% to 83% and 73% to 82%, respectively. Conclusion: The present study confirmed the predictive power of the variables using a noninvasive individualized methodology for tumor segmentation based on 18F-FDG PET/CT imaging for response evaluation in patients with rectal cancer after neoadjuvant chemoradiation therapy. |
Subject: | Neoplasias Retais Terapia Neoadjuvante Fluordesoxiglucose F18 Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada |
language: | eng |
metadata.dc.publisher.country: | Brasil |
Publisher: | Universidade Federal de Minas Gerais |
Publisher Initials: | UFMG |
metadata.dc.publisher.department: | MED - DEPARTAMENTO DE ANATOMIA E IMAGEM MED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL |
Rights: | Acesso Aberto |
metadata.dc.identifier.doi: | https://doi.org/10.1590/1806-9282.64.02.119 |
URI: | http://hdl.handle.net/1843/55178 |
Issue Date: | 17-Jul-2017 |
metadata.dc.url.externa: | https://www.scielo.br/j/ramb/a/ZxzXM5kmVRNzgzzSkXSL9BL/?lang=en |
metadata.dc.relation.ispartof: | Revista da Associação Médica Brasileira |
Appears in Collections: | Artigo de Periódico |
Files in This Item:
File | Description | Size | Format | |
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Individualized threshold for tumor pdfa.pdf | 326.22 kB | Adobe PDF | View/Open |
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