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Additional Value of 2-[18 F]Fdg Pet/Ct Comparing to Mri in Treatment Approach of Anal Cancer Patients Publisher



Manafifarid R1, 2 ; Kupferthaler A3 ; Wundsam H4 ; Gruber G5 ; Vali R6 ; Venhoda C5 ; Track C5 ; Beheshti A2, 7 ; Langsteger W2, 8 ; Geinitz H5 ; Beheshti M2, 9, 10
Authors
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Authors Affiliations
  1. 1. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, 1411713135, Iran
  2. 2. Department of Nuclear Medicine & Endocrinology, PET-CT Center LINZ, Ordensklinikum Linz Barmherzige Schwestern, Linz, 4020, Austria
  3. 3. Department of Radiology, Ordensklinikum Linz Barmherzige Schwestern, Linz, 4020, Austria
  4. 4. Department of Visceral Surgery, Ordensklinikum Linz Barmherzige Schwestern, Linz, 4020, Austria
  5. 5. Department of Radiation Oncology, Ordensklinikum Linz Barmherzige Schwestern, Linz, 4020, Austria
  6. 6. Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, M5G 1X8, ON, Canada
  7. 7. Faculty of Medicine, Ludwig Maximilian University, Munich, 80539, Germany
  8. 8. Department of Nuclear Medicine, Medical University of Vienna, Vienna, 1090, Austria
  9. 9. Department of Nuclear Medicine, University Hospital, RWTH University, Aachen, 52074, Germany
  10. 10. Department of Nuclear Medicine, Paracelsus Medical University, Salzburg, 5020, Austria

Source: Journal of Clinical Medicine Published:2020


Abstract

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-[18 F]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. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
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