Skip to main content

Advertisement

Log in

Clinical impact of PET/MR in treated colorectal cancer patients

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The primary aim of the present study was to evaluate if PET/MR induced management changes versus standard of care imaging (SCI) in treated colorectal cancer patients. The secondary aim was to assess the staging performance of PET/MR and of SCI versus the final oncologic stage.

Methods

Treated CRC patients who underwent PET/MR with 18F-FDG and SCI between January 2016 and October 2018 were enrolled in this retrospective study. Their medical records were evaluated to ascertain if PET/MR had impacted on their clinical management versus SCI. The final oncologic stage, as reported in the electronic medical record, was considered the true stage of disease.

Results

A total of 39 patients who underwent 42 PET/MR studies were included, mean age 56.7 years (range 39–75 years), 26 males, and 13 females. PET/MR changed clinical management 15/42 times (35.7%, standard error ± 7.4%); these 15 changes in management were due to upstaging in 9/42 (21.5%) and downstaging in 6/42 (14.2%). The differences in management prompted by SCI versus PET/MR were statistically significant, and PET/MR outperformed SCI (P value < 0.001; odds ratio = 2.8). In relation to the secondary outcome, PET/MR outperformed the SCI in accuracy of oncologic staging (P value = 0.016; odds ratio = 4.6).

Conclusions

PET/MR is a promising imaging tool in the evaluation of treated CRC and might change the management in these patients. However, multicenter prospective studies with larger patient samples are required in order to confirm these preliminary results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2018.

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34.

    Article  Google Scholar 

  3. Liu P-H, Wu K, Ng K, Zauber AG, Nguyen LH, Song M, et al. Association of obesity with risk of early-onset colorectal cancer among women. JAMA Oncol. 2018.

  4. Aklilu M, Eng C. The current landscape of locally advanced rectal cancer. Nat Rev Clin Oncol. 2011;8:649–59.

    Article  CAS  PubMed  Google Scholar 

  5. Wilhelmsen M, Kring T, Jorgensen LN, Madsen MR, Jess P, Bulut O, et al. Determinants of recurrence after intended curative resection for colorectal cancer. Scand J Gastroenterol. 2014;49:1399–408.

    Article  PubMed  Google Scholar 

  6. Tsikitis VL, Larson DW, Huebner M, Lohse CM, Thompson PA. Predictors of recurrence free survival for patients with stage II and III colon cancer. BMC Cancer. 2014;14:336.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Maas M, Rutten IJG, Nelemans PJ, Lambregts DMJ, Cappendijk VC, Beets GL, et al. What is the most accurate whole-body imaging modality for assessment of local and distant recurrent disease in colorectal cancer? A meta-analysis: imaging for recurrent colorectal cancer. Eur J Nucl Med Mol Imaging. 2011;38:1560–71.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Colosio A, Soyer P, Rousset P, Barbe C, Nguyen F, Bouché O, et al. Value of diffusion-weighted and gadolinium-enhanced MRI for the diagnosis of pelvic recurrence from colorectal cancer. J Magn Reson Imaging. 2014;40:306–13.

    Article  PubMed  Google Scholar 

  9. Wetter A, Grueneisen J, Umutlu L. PET/MR imaging of pelvic malignancies. Eur J Radiol. 2017;94:A44–51.

    Article  PubMed  Google Scholar 

  10. Catalano OA, Rosen BR, Sahani DV, Hahn PF, Guimaraes AR, Vangel MG, et al. Clinical impact of PET/MR imaging in patients with cancer undergoing same-day PET/CT: initial experience in 134 patients--a hypothesis-generating exploratory study. Radiology. 2013;269:857–69.

    Article  PubMed  Google Scholar 

  11. Catalano OA, Coutinho AM, Sahani DV, Vangel MG, Gee MS, Hahn PF, et al. Colorectal cancer staging: comparison of whole-body PET/CT and PET/MR. Abdom Radiol (NY). 2017;42:1141–51.

    Article  Google Scholar 

  12. Kang B, Lee JM, Song YS, Woo S, Hur BY, Jeon JH, et al. Added value of integrated whole-body PET/MRI for evaluation of colorectal cancer: comparison with contrast-enhanced MDCT. AJR Am J Roentgenol. 2016;206:W10–20.

    Article  PubMed  Google Scholar 

  13. Westberg K, Palmer G, Hjern F, Johansson H, Holm T, Martling A. Management and prognosis of locally recurrent rectal cancer - a national population-based study. Eur J Surg Oncol. 2018;44:100–7.

    Article  PubMed  Google Scholar 

  14. Charnsangavej C, Clary B, Fong Y, Grothey A, Pawlik TM, Choti MA. Selection of patients for resection of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol. 2006;13:1261–8.

    Article  PubMed  Google Scholar 

  15. Glehen O, Kwiatkowski F, Sugarbaker PH, Elias D, Levine EA, De Simone M, et al. Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004;22:3284–92.

    Article  CAS  Google Scholar 

  16. Odalovic S, Stojiljkovic M, Sobic-Saranovic D, Pandurevic S, Brajkovic L, Milosevic I, et al. Prospective study on diagnostic and prognostic significance of postoperative FDG PET/CT in recurrent colorectal carcinoma patients: comparison with MRI and tumor markers. Neoplasma. 2017;64:954–61.

    Article  CAS  PubMed  Google Scholar 

  17. Lu Y-Y, Chen J-H, Chien C-R, Chen WT-L, Tsai S-C, Lin W-Y, et al. Use of FDG-PET or PET/CT to detect recurrent colorectal cancer in patients with elevated CEA: a systematic review and meta-analysis. Int J Color Dis. 2013;28:1039–47.

    Article  Google Scholar 

  18. Delbeke D, Martin WH. PET and PET-CT for evaluation of colorectal carcinoma. Semin Nucl Med. 2004;34:209–23.

    Article  PubMed  Google Scholar 

  19. Plodeck V, Rahbari NN, Weitz J, Radosa CG, Laniado M, Hoffmann R-T, et al. FDG-PET/MRI in patients with pelvic recurrence of rectal cancer: first clinical experiences. Eur Radiol. 2018.

  20. Brendle C, Schwenzer NF, Rempp H, Schmidt H, Pfannenberg C, la Fougère C, et al. Assessment of metastatic colorectal cancer with hybrid imaging: comparison of reading performance using different combinations of anatomical and functional imaging techniques in PET/MRI and PET/CT in a short case series. Eur J Nucl Med Mol Imaging. 2016;43:123–32.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was supported in part by the Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP 2017/27205-2), Brazil.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Onofrio A. Catalano.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study had been conducted under IRB approval granted by Partners Healthcare Institutional Review Board (IRB), Protocol no. 2018P001334. Patient consent has been waived by IRB.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Oncology – Digestive tract

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amorim, B.J., Hong, T.S., Blaszkowsky, L.S. et al. Clinical impact of PET/MR in treated colorectal cancer patients. Eur J Nucl Med Mol Imaging 46, 2260–2269 (2019). https://doi.org/10.1007/s00259-019-04449-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-019-04449-7

Keywords

Navigation