Article Figures & Data
Figures
- FIGURE 1.
Relative reductions of 18F-FDG uptake, measured either by SUV-max (black boxes) or SUV-mean (white boxes), during the study. Boxes represent interquartile distribution. Horizontal bars within boxes are median values. Error bars are 10th and 90th percentiles.
- FIGURE 2.
Early changes of SUV-max (A) and of SUV-mean (B) relative to TRG values.
- FIGURE 3.
Time course of 18F-FDG PET in a nonresponder patient (patient 1). (A) Intense 18F-FDG uptake in baseline study clearly depicts irregular tumor mass. (B) Tumor uptake is roughly unchanged in intermediate study (early SUV change, −15%). (C) In presurgical study, tumor volume is reduced but considerable tumor uptake is still present (late SUV change, −23%). This case was graded TRG4.
- FIGURE 4.
Time course of 18F-FDG PET in a responder patient (patient 31). (A) Intense 18F-FDG uptake is evident on baseline scan in a T2 lesion. (B) Significant decrease of SUV is observed on the intermediate scan. Early SUV change was −62%. (C) Complete tumor disappearance is noted on presurgical scan. Subtotal tumor regression (TRG2) was achieved. Activity in left ureter can be seen on transaxial images. n.m. = not measurable.
- FIGURE 5.
ROC curve analysis for early SUV changes in discriminating responder and nonresponder patients. Cutoff value in SUV-mean (closed circles) change of −52% yields values of 100% in sensitivity and specificity, whereas cutoff value in SUV-max (open boxes) of −42% gives a sensitivity of 100% and a specificity of 87% (area under curve, 0.95; confidence interval, 95%).
Tables
- TABLE 1
Patient Characteristics, Clinical Staging, Histopathologic Findings, and Tumor 18F-FDG SUV-mean Changes
Patient no. Sex Age (y) cTNM cMRC GR Tumor location pTNM TRG R status Baseline Intermediate Before surgery Early change (%) Overall change (%) 1 F 29 T4 N2 ≤5 mm High ≤5 cm T4 N0 4 R1 4.15 3.54 2.74 14.69 33.9 2 F 66 T3 N0 >5 mm Interm. ≤5 cm T1 N0 2 R0 10.6 4.5 NP 57.60 3 M 69 T3 N1 ≤5 mm Mod. high ≤5 cm T0 N0 1 R0 16.2 4.25 NM 73.76 100.0 4 F 57 T2 N1 >5 mm Interm. ≤5 cm T2 N0 4 R0 4.75 4.28 NM 9.89 100.0 5 F 73 T3 N1 >5 mm Mod. high >5 cm T0 N0 1 R0 4.06 1.26 NP 68.90 6 M 60 T4 N1 ≤5 mm High ≤5 cm T3 N1 3 R1 4.68 4.57 NP 2.35 7 M 74 T3 N0 ≤5 mm Interm. >5 cm T0 N0 1 R0 5.37 1.89 NP 64.80 8 M 48 T3 N1 NP Mod. high >5 cm T3 N1 3 R0 8.03 7.35 NP 8.46 9 M 67 T3 N1 ≤5 mm Mod. high >5 cm T0 N0 1 R0 7.37 1.91 NP 74.00 10 M 48 T3 N2 ≤5 mm High >5 cm T0 N0 1 R0 4.97 2.12 NM 57.34 100.0 11 M 66 T3 N1 >5 mm Mod. high >5 cm T0 N0 1 R0 10.03 3.21 NM 67.98 100.0 12 F 40 T3 N2 >5 mm High >5 cm T2 N2 3 R0 11.7 9.1 6.3 22.20 46.2 13 M 70 T3 N1 NP Mod. high >5 cm T2 N1 3 R0 7.19 3.76 NM 47.70 100.0 14 M 53 T3 N1 >5 mm Mod. high >5 cm T2 N0 3 R0 4.55 4.03 2.01 11.42 55.8 15 F 42 T3 N1 >5 mm Mod. high >5 cm T0 N1 1 R0 9.52 3.62 2.07 61.97 78.3 16 M 58 T3 N1 >5 mm Mod. high >5 cm T0 N0 1 R0 6.7 2.21 NM 67.01 100.0 17 F 30 T3 N1 ≤5 mm Mod. high >5 cm T0 N0 1 R0 9.08 NM NP 100.00 18 M 50 T3 N1 ≤5 mm Mod. high ≤5 cm T3 N1 3 R0 3.2 3.08 2.17 3.75 32.2 19 F 50 T3 N0 ≤5 mm Interm. ≤5 cm T2 N0 3 R0 6.34 3.94 2.11 37.85 66.0 20 F 52 T3 N1 ≤5 mm Mod. high ≤5 cm T2 N0 2 R0 6.8 3.02 2.1 55.58 67.6 21 F 64 T3 N1 ≤5 mm Mod. high >5 cm T3 N0 3 R0 7.68 4.85 2.52 36.84 67.1 22 M 67 T3 N1 >5 mm Mod. high ≤5 cm T3 N0 3 R0 8.03 6.23 NP 22.41 23 M 47 T3 N2 ≤5 mm High ≤5 cm T2 N0 2 R0 11.23 4.64 NP 58.68 24 M 53 T3 N2 ≤5 mm High ≤5 cm T3 N0 2 R0 8.87 3.62 NP 59.18 25 F 66 T3 N1 ≤5 mm Mod. high >5 cm T3 N0 3 R0 10.69 7.55 NP 29.37 26 F 58 T3 N1 NP Mod. high ≤5 cm T0 N0 1 R0 10.54 3.22 NP 69.44 27 M 69 T3 N1 ≤5 mm Mod. high ≤5 cm T3 N1 2 R0 13.75 5.67 NP 58.76 28 F 65 T4 N2 ≤5 mm High >5 cm T3 N1 3 R0 10.87 7.19 NP 33.85 29 M 64 T3 N0 ≤5 mm Interm. ≤5 cm T2 N0 3 R0 8.39 6.19 NP 26.22 30 M 41 T4 N0 ≤5 mm Mod. high ≤5 cm T2 N0 3 R0 9.67 7.21 NP 25.43 31 M 62 T2 N1 >5 mm Interm. >5 cm T1 N1 2 R0 6.3 2.4 NM 61.90 100.0 32 M 49 T3 N2 ≤5 mm High >5 cm T0 N0 1 R0 18.58 5.43 NM 70.75 100.0 33 M 36 T3 N0 ≤5 mm Interm. ≤5 cm T0 N0 1 R0 6.32 2.68 NM 57.6 100.0 cTNM = clinical TNM; cCRM = clinical CRM; pTNM = pathologic TNM; R status = resection status; R0 = macroscopically complete resection; R1 = minimal residue resection; GR = Gunderson risk classification (19); Interm = intermediate; Mod. high = moderately high; NM = not measurable; NP = not performed.
Clinical TN (n) Pathologic TN (n) TRG (n) T2N1 (2) T1N1 (1), T2N0 (1) TRG2 (1), TRG4 (1) T3N0 (5) T0N0 (2), T1N0 (1), T2N2 (2) TRG1 (2), TRG2 (1), TRG3 (2) T3N1 (17) T0N0 (7), T0N1 (1), T2N0 (2), T2N1 (1), T3N0 (3), T3N1 (3) TRG1 (8), TRG2 (2), TRG3 (7) T3N2 (5) T0N0 (2), T2N0 (1), T2N2 (1), T3N0 (1) TRG1 (2), TRG2 (2), TRG3 (1) T4N0 (1) T2N0 TRG3 (1) T4N1 (1) T3N1 TRG3 (1) T4N2 (2) T3N1 (1), T4N0 (1) TRG3 (1), TRG4 (1)
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