- Positron emission tomography-CT (PET-CT) imaging could identify patients with locally advanced rectal cancer who likely did not reach pathologic complete response (pCR) and should be considered for surgical management.
Why this matters
- Patients with a postchemoradiation PET-CT maximal standardized uptake value (SUVmax) >4.3 are unlikely to have achieved pCR and should be considered for operative management.
- Retrospective analysis of 125 patients at a single center.
- Funding: None.
- Patients with pCR had lower post-CRT SUVmax (3.2 vs 5.2 [P=.0009]; 72% decrease vs 58% [P=.0035]).
- Post-CRT SUVmax max percentage decrease of more than 66% predicted pCR (sensitivity, 65%; specificity, 72%; positive predictive value [PPV], 44%; negative predictive value [NPV], 86%).
- Combined SUVmax decrease of >66% and post-CRT SUVmax
- pCR was associated with a median recurrence-free survival (RFS) of 81% vs 55% (P=.04), but no significant difference in 5-year OS (82% vs 65%; P=.085).
- Post-CRT SUVmax
- Retrospective analysis, single center.