Evidence map›Paper›PMID 41317281›Full record

ArticleJournal of gastrointestinal cancer2025

Role of 18FDG PET-CT & MRI for Predicting Response to Neo-Adjuvant Therapy in Rectal Cancer.

Kaushik Jaganathan, Shaifali Goel, Abhishek Aggarwal, Asif Iqbal, Prerna Garg, Shivendra Singh

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Article in Journal of gastrointestinal cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kaushik JaganathanDepartment of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and research centre, Room no 3168, First floor, D- Block, Sector -5, Rohini, Delhi, 110085, India.
Shaifali GoelDepartment of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and research centre, Room no 3168, First floor, D- Block, Sector -5, Rohini, Delhi, 110085, India.
Abhishek AggarwalDepartment of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and research centre, Room no 3168, First floor, D- Block, Sector -5, Rohini, Delhi, 110085, India.
Asif IqbalDepartment of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and research centre, Room no 3168, First floor, D- Block, Sector -5, Rohini, Delhi, 110085, India.
Prerna GargDepartment of Imaging and Radiodiagnosis, Rajiv Gandhi Cancer Institute and research centre, Sector -5, Rohini, Delhi, 110085, India.
Shivendra SinghDepartment of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and research centre, Room no 3168, First floor, D- Block, Sector -5, Rohini, Delhi, 110085, India. shiven_24@yahoo.co.in.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNeoadjuvant chemoradiotherapy (NACRT) is standard for locally advanced rectal cancer. Accurate response assessment is essential, particularly to identify complete responders eligible for organ-preserving strategies. While MRI is widely used, 18 F-FDG PET-CT has been proposed as a complementary modality. This study compared MRI-based Tumor Regression Grade (mrTRG) and PET-CT parameters in predicting pathological response.

methodsA retrospective analysis was conducted at Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, from January 2013 to May 2024. A total of 268 patients underwent MRI and PET-CT before and after NACRT, followed by surgery. Response was categorized using mrTRG and pathological TRG (pTRG). PET-CT response was assessed by changes in SUVmax. Diagnostic accuracy of mrTRG and PET-CT was evaluated using statistical tests, kappa agreement, and ROC curves.

resultsOf 268 patients, 27.2% were classified as good responders (mrTRG 1-2), whereas 46.2% had good pathological response (pTRG 0-1). The correlation between mrTRG and pTRG was weak (kappa = 0.215). PET-CT showed a mean SUVmax reduction of 58.2%, with greater decline in responders. However, ROC analysis demonstrated poor discriminative ability (AUC = 0.502), indicating no advantage over MRI. Combining MRI and PET-CT imaging slightly improved accuracy in matching pathological grading (κ = 0.36).

conclusionMRI remains the preferred modality for post-NACRT response assessment in rectal cancer, showing moderate predictive accuracy. PET-CT, despite reflecting metabolic changes, is not reliable in distinguishing complete responders. A combined multimodal approach may improve evaluation and support individualized treatment planning.

Indexed as

Magnetic Resonance ImagingNeoadjuvant TherapyPositron Emission Tomography Computed TomographyRectal NeoplasmsAdultAgedFemaleFluorodeoxyglucose F18HumansMaleMiddle AgedRadiopharmaceuticalsRetrospective StudiesTreatment OutcomeFluorodeoxyglucose F18Radiopharmaceuticals18F-FDG PET-CTMRINeoadjuvant therapyPathological response.Rectal cancerTumor regression grade

Identifiers

PMID41317281

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