Quantitative imaging outperforms molecular markers when predicting response to chemoradiotherapy for rectal cancer

被引:35
作者
Joye, Ines [1 ,2 ]
Debucquoy, Annelies [1 ]
Deroose, Christophe M. [3 ]
Vandecaveye, Vincent [4 ]
Van Cutsem, Eric [5 ]
Wolthuis, Albert [6 ]
D'Hoore, Andre [6 ]
Sagaert, Xavier [7 ]
Zhou, Mu [8 ]
Gevaert, Olivier [8 ]
Haustermans, Karin [1 ,2 ]
机构
[1] KU Leuven Univ Leuven, Dept Oncol, B-3000 Leuven, Belgium
[2] Univ Hosp Leuven, Radiat Oncol, B-3000 Leuven, Belgium
[3] Univ Hosp Leuven, Nucl Med, B-3000 Leuven, Belgium
[4] Univ Hosp Leuven, Radiol, B-3000 Leuven, Belgium
[5] Univ Hosp Leuven, Digest Oncol, B-3000 Leuven, Belgium
[6] Univ Hosp Leuven, Abdominal Surg, B-3000 Leuven, Belgium
[7] Univ Hosp Leuven, Pathol, B-3000 Leuven, Belgium
[8] Stanford Univ, Stanford Ctr Biomed Informat Res, Med, Stanford, CA 94305 USA
关键词
Rectal cancer; Chemoradiotherapy; Response prediction; Imaging; Molecular markers; TOTAL MESORECTAL EXCISION; COMPLETE PATHOLOGICAL RESPONSE; GENE-EXPRESSION; PREOPERATIVE CHEMORADIOTHERAPY; NEOADJUVANT CHEMORADIATION; FOLLOW-UP; RADIOTHERAPY; RECURRENCE; SURVIVAL; MRI;
D O I
10.1016/j.radonc.2017.06.013
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and purpose: To explore the integration of imaging and molecular data for response prediction to chemoradiotherapy (CRT) for rectal cancer. Material and methods: Eighty-five rectal cancer patients underwent preoperative CRT. F-18-FDG PET/CT and diffusion-weighted imaging (DWI) were acquired before (TP1) and during CRT (TP2) and prior to surgery (TP3). Inflammatory cytokines and gene expression were analysed. Tumour response was defined as ypT0-1N0. Multivariate models were built combining the obtained parameters. Final models were calculated on the data combination with the highest AUC. Results: Twenty-two patients (26%) achieved ypT0-1N0 response. F-18-FDG PET/CT had worse predictive performance than DWI and T2-volumetry (AUC 0.61 +/- 0.04, 0.72 +/- 0.03, and 0.72 +/- 0.02, respectively). Combining all imaging parameters increased the AUC to 0.81 +/- 0.03. Adding cytokines or gene expression did not improve the AUC (AUC of 0.72 +/- 0.06 and 0.79 +/- 0.04 respectively). Final models combining F-18-FOG PET/CT, DWI, and T2-weighted volumetry at all TPs and using only TP1 and TP3, allowed ypT0-1N0 prediction with a 75% sensitivity, 94% specificity and PPV of 80%. Conclusions: Combining 18F-FDG PET/CT, DWI, and T2-weighted MRI volumetry obtained before CRT and prior to surgery may help physicians in selecting rectal cancer patients for organ-preservation. 2017 Elsevier B.V. All rights reserved.
引用
收藏
页码:104 / 109
页数:6
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