title: Systematic review of FDG-PET prediction of complete pathological response and survival in rectal cancer.
abstract: BACKGROUND
  Advances in the management of rectal cancer have resulted in an increased application of multimodal therapy with the aim of tailoring therapy to individual patients. Complete pathological response (pCR) is associated with improved survival and may be potentially managed without radical surgical resection. Over the last decade, there has been increasing interest in the ability of functional imaging to predict complete response to treatment. The aim of this review was to assess the role of (18)F-flurordeoxyglucose positron emission tomography (FDG-PET) in prediction of pCR and prognosis in resectable locally advanced rectal cancer.
  
  
  METHODS
  A search of the MEDLINE and Embase databases was conducted, and a systematic review of the literature investigating positron emission tomography (PET) in the prediction of pCR and survival in rectal cancer was performed.
  
  
  RESULTS
  Seventeen series assessing PET prediction of pCR were included in the review. Seven series assessed postchemoradiation SUVmax, which was significantly different between response groups in all six studies that assessed this. Nine series assessed the response index (RI) for SUVmax, which was significantly different between response groups in seven series. Thirteen studies investigated PET response for prediction of survival. Metabolic complete response assessed by SUV2max or visual response and RISUVmax showed strong associations with disease-free survival (DFS) and overall survival (OS).
  
  
  CONCLUSIONS
  SUV2max and RISUVmax appear to be useful FDG-PET markers for prediction of pCR and these parameters also show strong associations with DFS and OS. FDG-PET may have a role in outcome prediction in patients with advanced rectal cancer.
authors.affiliation: Department of Colorectal Surgery, Division of Cancer Surgery, Peter MacCallum Cancer Centre, East Melbourne, University of Melbourne, Parkville, Australia.
authors.forename: Sameer
authors.initials: S
authors.lastname: Memon
authors.forename: A Craig
authors.initials: AC
authors.lastname: Lynch
authors.forename: Timothy
authors.initials: T
authors.lastname: Akhurst
authors.forename: Samuel Y
authors.initials: SY
authors.lastname: Ngan
authors.forename: Satish K
authors.initials: SK
authors.lastname: Warrier
authors.forename: Michael
authors.initials: M
authors.lastname: Michael
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Heriot
mesh_terms: D003131:Combined Modality Therapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18