Anal cancer FDG-PET standard uptake value: correlation with tumor characteristics, treatment response and survival

Deantonio, Letizia; Milia, Maria Elisa; Cena, Tiziana; Sacchetti, Gianmauro; Perotti, C.; Brambilla, Marco; Turri, Lucia; Krengli, Marco

doi:10.1007/s11547-015-0562-9

Cited by 34 publications

(25 citation statements)

References 34 publications

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“…This is in line with the results of a prospectively conducted study of Deantonio et al including 55 patients. They observed a statistically significant correlation between SUV max and T-stage of patients and no association with treatment response or survival of patients [12]. Similarly, baseline PET uptake parameters such as SUV max and SUV mean and MTV had no impact on long-term outcomes in our cohort.…”

Section: Discussionmentioning

confidence: 47%

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Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

Braun

Reinert

Zips

et al. 2020

Clinical and Translational Radiation Oncology

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Background: Anal cancer (AC) is a malignancy with increasing incidence and commonly treated with radiochemotherapy. Positron-emission tomography-computed tomography (PET/CT) has been shown to improve treatment outcome in various oncological diseases, however, for AC long-term outcome data is sparse. The aim of the present study is therefore to report outcomes in our cohort of PET/CT staged AC patients treated with radiochemotherapy. Methods: Patients with AC who were treated with radiochemotherapy in curative intent were included in this retrospective study if a PET/CT scan was performed pre-therapeutically. Information from PET/CT was considered for nodal and primary target volume definition. Radiotherapy dose to the primary tumor was 50-66 Gy and concomitant chemotherapy included 5-fluorouracil and mitomycin-C. The uptake of 18 F-fluorodeoxyglucose (FDG) was quantified using 50%-isocontour volumes of interests (VOIs) and measuring the standardized uptake value (SUV) and the metabolic tumor volume (MTV). 18 F-FDG uptake was correlated with baseline clinical parameters and long-term oncological outcome. Survival estimates were determined according to Kaplan-Meier. Results: A total of 60 patients were included in this study. Estimates for three-year overall survival (OS) and disease free survival (DFS) were 94.5% and 80%. Five patients developed local (n = 2) or locoregional and local (n = 3) failure. Baseline PET/CT related parameters correlated with primary tumor stage, nodal stage and tumor grading. DFS was independent of T-stage, N-stage and baseline 18 F-FDG-uptake. Conclusion: In this cohort of PET/CT staged AC patients, excellent outcomes for DFS were seen. PET-based markers of tumor burden correlate with local stage of AC, however, are not of prognostic relevance for disease-free survival.

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Section: Discussionmentioning

confidence: 47%

“…Also for anal cancer, the role of PET-CT especially for disease staging and its impact on target volume definition has been studied before [10][11]. Several studies investigated the association of pretherapeutic PET-CT parameters with the oncological outcome of patients with anal cancer, with partly conflicting results [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

Braun

Reinert

Zips

et al. 2020

Clinical and Translational Radiation Oncology

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“…SUV max/peak/mean were non-significant predictors, which underlines the uncertain predictive value of SUV max for anal cancers. 15,20,38,39 TLG has previously been associated with treatment outcome for other cancer types, 40,41 and was found to be GTV, gross tumor volume; HPV, human papilloma virus; MTV, metabolic tumor volume; SUV, standardized uptake value; TLG, total lesion glycolysis. The abscissa signifies the p-value and hazard ratio of a parameter (column) when paired with a variable on the ordinate (row).…”

Section: Discussionmentioning

confidence: 97%

Anal cancer chemoradiotherapy outcome prediction using 18F-fluorodeoxyglucose positron emission tomography and clinicopathological factors

Rusten

Rekstad

Undseth

et al. 2019

The British Journal of Radiology

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Anal cancer is a rare disease with increasing incidence 1,2 and chemoradiotherapy is the recommended curative treatment. 3 State-of-the-art radiotherapy is delivered as intensity modulated radiation therapy (IMRT) with concomitant mitomycin (MMC) and 5-fluorouracil (5-FU) chemotherapy. 4,5 Different treatment regimens are used based on tumor and lymph node stage. 3 Complete tumor remission may be achieved in up to 90% of the patients and the 3 year progression-free survival is around 70%. 6 Recurrences are mostly locoregional 7,8 and curatively intended salvage surgery usually involves extensive pelvic surgery. 9 The majority of anal squamous cell carcinomas are HPV positive, and HPV status is both a prognostic factor and predictive of treatment outcome. 10,11 Other clinicopathological features such as gender, tumor and lymph node stage, radiotherapy dose, and tumor-infiltrating lymphocytes have shown prognostic value, 11-13 but there is currently no

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“…Positron emission tomography with fluorodeoxyglucose (FDG-PET) is recommended for the initial staging of anal SCC with detection of inguinal and pelvic lymph node involvement [19][20][21][22][23][24][25][26][27]. In recent years, several teams have investigated the prognostic value of semiquantitative PET data during pretherapy, post-therapy and the metabolic response phases of this pathology [20,[28][29][30][31][32][33][34]. While these studies showed a prognostic value for the MTV (metabolic tumour volume) using pretherapeutic FDG-PET, the methods for tumour mass segmentation are heterogeneous, with different fixed thresholds because of easier routine clinical use and the absence of a standardized method.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer

Thiec

Testard²,

Ferrer

et al. 2020

Cancers

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Due to the heterogeneity of tumour mass segmentation methods and lack of consensus, our study evaluated the prognostic value of pretherapeutic positron emission tomography with fluorodeoxyglucose (FDG-PET) metabolic parameters using different segmentation methods in patients with localized anal squamous cell carcinoma (SCC). Eighty-one patients with FDG-PET before radiochemotherapy were retrospectively analyzed. Semiquantitative data were measured with three fixed thresholds (35%, 41% and 50% of Maximum Standardized Uptake Value (SUVmax)) and four segmentation methods based on iterative approaches (Black, Adaptive, Nestle and Fitting). Metabolic volumes of primary anal tumour (P-MTV) and total tumour load (T-MTV: P-MTV+ lymph node MTV) were calculated. The primary endpoint was event-free survival (EFS). Seven multivariate models were created to compare FDG-PET tumour volumes prognostic impact. For all segmentation thresholds, PET metabolic volume parameters were independent prognostic factor and T-MTV variable was consistently better associated with EFS than P-MTV. Patient’s sex was an independent variable and significantly correlated with EFS. With fixed threshold segmentation methods, 35% of SUVmax threshold seemed better correlated with EFS and the best cut-off for discrimination between a low and high risk of event occurrence was 40 cm3. Determination of T-MTV by FDG-PET using fixed threshold segmentation is useful for predicting EFS for primary anal SCC. If these data are confirmed in larger studies, FDG-PET could contribute to individualized patient therapies.

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Anal cancer FDG-PET standard uptake value: correlation with tumor characteristics, treatment response and survival

Cited by 34 publications

References 34 publications

Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

Treatment outcome after radiochemotherapy in anal cancer patients staged with 18F-FDG-PET-CT

Anal cancer chemoradiotherapy outcome prediction using 18F-fluorodeoxyglucose positron emission tomography and clinicopathological factors

Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer

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