PET-Based Treatment Response Evaluation in Rectal Cancer: Prediction and Validation

Abstract

For rectal cancer, an accurate PET-based prediction of the pathological treatment response is feasible already after 2 weeks of CRT. The presented predictive model could be used to select patients to be considered for less invasive surgical interventions or even a "wait and see" policy. Also, based on the predicted response, early modifications of the treatment protocol are possible, which might result in an improved clinical outcome.

Is the Standardized Uptake Value of FDG-PET/CT Predictive of Pathological Complete Response in Locally Advanced Rectal Cancer Treated with Capecitabine-Based Neoadjuvant Chemoradiation?

“…Similarly, other studies reported that negative posttreatment FDG-PET and/or a metabolic response was associated with better disease outcomes [32,34,35]. On the contrary, PET failed to distinguish patients with pCR from those without pCR, when rarely used for early metabolic assessment 2 weeks after the start of neoadjuvant CRT [36,37]. …”

MRI volumetry for prediction of tumour response to neoadjuvant chemotherapy followed by chemoradiotherapy in locally advanced rectal cancer

“…[29][30][31][32] However, the acquisition and evaluation of these additional sequences demand more resources, prolonged scan time and additional time for interpretation. Aiba et al 17 found that the addition of 18 F-FDG PET to MRI volumetry did not improve the performance of NACT response assessment.…”

Chimioradiothérapie préopératoire du cancer du rectum : expérience d’un centre

“…Cinq cancers seulement ont récidivé localement, ils ont tous été opérés en permettant d'assurer le contrôle local. Certains patients sélectionnés par des examens de biologie moléculaire [43,44], des examens d'imagerie performants (IRM, tomographie par émission de positons) [45][46][47], permettant de prédire la réponse complète, pourraient sans doute bénéficier d'une chimioradiothérapie exclusive. Un essai prospectif concernant cette question est actuellement en cours en Angleterre [48].…”