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Title: Value of Primary Rectal Tumor PET/MRI in the Prediction of Synchronic Metastatic Disease
Authors: QUEIROZ, Marcelo A.ORTEGA, Cinthia D.FERREIRA, Felipe R.CAPARELI, Fernanda C.NAHAS, Sergio C.CERRI, Giovanni G.BUCHPIGUEL, Carlos A.
Citation: MOLECULAR IMAGING AND BIOLOGY, v.24, n.3, p.453-463, 2022
Abstract: Purpose: To analyze the associations between positron emission tomography (PET)/magnetic resonance imaging (MRI) features for primary rectal tumors and metastases. Procedures: Between November 2016 and April 2018, 101 patients with rectal adenocarcinoma were included in this prospective study (NCT02537340) for whole-body PET/MRI for baseline staging. Two readers analyzed the PET/MRI; they assessed the semiquantitative PET features of the primary tumor and the N- and M-stages. Another reader analyzed the MRI features for locoregional staging. The reference standard for confirming metastatic disease was biopsy or imaging follow-up. Nonparametric tests were used to compare the PET/MRI features of the participants with or without metastatic disease. Binary logistic regression was used to evaluate the associations between the primary tumor PET/MRI features and metastatic disease. Results: A total of 101 consecutive participants (median age 62 years; range: 33-87 years) were included. Metastases were detected in 35.6% (36 of 101) of the participants. Among the PET/MRI features, higher tumor lesion glycolysis (352.95 vs 242.70; P =.46) and metabolic tumor volume (36.15 vs 26.20; P =.03) were more frequent in patients with than in those without metastases. Additionally, patients with metastases had a higher incidence of PET-positive (64% vs 32%; P =.009) and MRIpositive (56% vs 32%; P =.03) mesorectal lymph nodes, extramural vascular invasion (86% vs 49%; P >.001), and involvement of mesorectal fascia (64% vs 42%; P =.04); there were also differences between the mrT stages of these two groups (P =.008). No differences in the maximum standardized uptake values for the primary tumors in patients with and without metastases were observed (18.9 vs 19.1; P =.56). Multivariable logistic regression showed that extramural vascular invasion on MRI was the only significant predictor (adjusted odds ratio, 3.8 [95% CI: 1.1, 13.9]; P =.001). Conclusion: PET/MRI facilitated the identification of participants with a high risk of metastatic disease, though these findings were based mainly on MRI features.
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Artigos e Materiais de Revistas Científicas - FM/MDR
Departamento de Radiologia - FM/MDR

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Departamento de Gastroenterologia - FM/MGT

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Instituto do Câncer do Estado de São Paulo - HC/ICESP

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Instituto do Coração - HC/InCor

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Instituto de Radiologia - HC/InRad

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LIM/43 - Laboratório de Medicina Nuclear

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