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Manafi-Farid, Reyhaneh; Kupferthaler, Alexander; Wundsam, Helwig; Gruber, Georg; Vali, Reza; Venhoda, Clemens; Track, Christine; Beheshti, Ali; Langsteger, Werner; Geinitz, Hans und Beheshti, Mohsen (2020): Additional Value of 2-[F-18]FDG PET/CT Comparing to MRI in Treatment Approach of Anal Cancer Patients. In: Journal of Clinical Medicine, Bd. 9, Nr. 9, 2715

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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-[F-18]fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (2-[F-18]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-[F-18]FDG PET/CT studies and MRI reports were compared considering the primary tumor, pelvic lymph nodes, and metastatic lesions. The impact of 2-[F-18]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-[F-18]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-[F-18]FDG PET/CT resulted in management change in 24.1% of patients. Finally, SUVmax provided no prognostic value. 2-[F-18]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.

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