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?

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dc.creatorTheara C.fagundes
dc.creatorMarcelo Mamede
dc.creatorArnoldo Mafra
dc.creatorRodrigo g. Silva
dc.creatorAna c. g. Castro
dc.creatorLuciana c. Silva
dc.creatorPriscilla t. Aguiar
dc.creatorJosiane a. Silva
dc.creatorEduardo Paulino Júnior
dc.creatorAlexei m. Machado
dc.date.accessioned2023-06-20T20:03:08Z
dc.date.accessioned2025-09-09T00:16:22Z
dc.date.available2023-06-20T20:03:08Z
dc.date.issued2017-07-17
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1590/1806-9282.64.02.119
dc.identifier.issn18069282
dc.identifier.urihttps://hdl.handle.net/1843/55178
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofRevista da Associação Médica Brasileira
dc.rightsAcesso Aberto
dc.subjectNeoplasias Retais
dc.subjectTerapia Neoadjuvante
dc.subjectFluordesoxiglucose F18
dc.subjectTomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
dc.subject.otherRectal Neoplasms
dc.subject.otherNeoadjuvant Therapy
dc.subject.other18F-FDG
dc.subject.otherPET/CT
dc.titleIndividualized threshold for tumor segmentation in 18F-FDG PET/CT imaging: the key for response evaluation of neoadjuvant chemoradiation therapy in patients with rectal cancer?
dc.typeArtigo de periódico
local.citation.epage126
local.citation.issue2
local.citation.spage119
local.citation.volume64
local.description.resumoIntroduction: 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.
local.identifier.orcidhttps://orcid.org/0000-0001-6157-6511
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE ANATOMIA E IMAGEM
local.publisher.departmentMED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL
local.publisher.initialsUFMG
local.url.externahttps://www.scielo.br/j/ramb/a/ZxzXM5kmVRNzgzzSkXSL9BL/?lang=en

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