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Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer

Abstract : 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 cutoff for discrimination between a low and high risk of event occurrence was 40 cm 3. 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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Submitted on : Wednesday, July 29, 2020 - 2:24:04 PM
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Maëlle Le Thiec, Aude Testard, Ludovic Ferrer, Camille Guillerminet, Olivier Morel, et al.. Prognostic Impact of Pretherapeutic FDG-PET in Localized Anal Cancer. Cancers, MDPI, 2020, 12 (6), pp.1512. ⟨10.3390/cancers12061512⟩. ⟨inserm-02908736⟩



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