Prognostic utility of pre- and post-treatment FDG-PET parameters in anal squamous cell carcinoma

Duimering, Adele; Riauka, T.; Nijjar, Yugmel; Ghosh, Sunita; MacEwan, Robert; Warkentin, Heather; Schiller, Dan; Tankel, Keith; Usmani, Nawaid; Severin, Diane; Nijjar, Tirath; Fairchild, Alysa; Mulder, Karen; Doll, Corinne; Wong, Clarence; Joseph, Kurian

doi:10.1016/j.radonc.2019.03.014

Cited by 20 publications

(22 citation statements)

References 31 publications

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“…It is interesting that the majority of published studies have focused on the metabolic volume of the primary tumour (P-MTV) and found this to be prognostic for EFS [30,33,34], and in one study for OS [28]. In our study, whilst both T-MTV and P-MTV were prognostic, T-MTV was more relevant.…”

Section: Discussionmentioning

confidence: 42%

“…An important finding of our study is that FDG-PET visual analysis of bilateral pelvic lymph node involvement resulted in a pejorative independent prognostic factor (p = 0.018), whereas in previous studies this was only the case for the presence or not of inguinal lymph node involvement [34]. The improved precision in our study is due to the classification of six distinct anatomical areas that include all of the potential lymph node lesions, allowing precise localized analysis.…”

Section: Discussionmentioning

confidence: 55%

“…Whilst one limitation of our study lies in its retrospective nature, only three studies have been prospective [29,33,34], and the low incidence of this disease makes it difficult to carry out prospective studies. We analyzed a fairly large cohort of 81 patients treated according to standard protocols.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer

Thiec

Testard²,

Ferrer

et al. 2020

Cancers

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“…Moreover, it has been documented that T and N stages are prognostic factors related to survival [ 25 ]. Also, metabolic parameters derived from pre-therapy 2-[ 18 F]FDG PET/CT have been successfully employed for prognostication [ 26 , 27 , 28 ]. However, the intensity of the 2-[ 18 F]FDG uptake on the pre-treatment scan has shown controversial results in inversely corresponding to survival [ 26 , 29 , 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

Additional Value of 2-[18F]FDG PET/CT Comparing to MRI in Treatment Approach of Anal Cancer Patients

Manafi‐Farid

Kupferthaler

Wundsam

et al. 2020

JCM

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Accurate staging and treatment planning are imperative for precise management in Anal Cancer (ACa) patients. We aimed to evaluate the additive and prognostic value of pre-treatment 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) in the staging and management of ACa compared to magnetic resonance imaging (MRI). This retrospective study was conducted on 54 patients. Pre-treatment 2-[18F]FDG PET/CT studies and MRI reports were compared considering the primary tumor, pelvic lymph nodes, and metastatic lesions. The impact of 2-[18F]FDG PET/CT in the management and its prognostic value, using maximum standardized uptake value (SUVmax), were assessed. Discordant findings were found in 46.3% of patients (5 in T; 1 in T and N; 18 in N; and 1 in M stage). 2-[18F]FDG PET/CT resulted in up-staging in 9.26% and down-staging in 3.7% of patients. Perirectal lymph nodes were metabolically inactive in 12.9% of patients. Moreover, 2-[18F]FDG PET/CT resulted in management change in 24.1% of patients. Finally, SUVmax provided no prognostic value. 2-[18F]FDG PET/CT altered staging and management in a sizable number of patients in this study, and supports a need for a change in guidelines for it to be used as a routine complementary test in the initial management of ACa.

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