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Prediction of pathological response to neoadjuvant immunochemotherapy with baseline and post-treatment 18F-FDG PET imaging biomarkers in patients with locally advanced gastric cancer

  • 0Department of Nuclear Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Bmc Cancer +

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February 28, 2025

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February 28, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Neoadjuvant immunochemotherapy (NICT) for locally advanced gastric cancer (LAGC) shows promise. Baseline and post-treatment 18F-FDG PET/CT metabolic parameters can predict pathological response to NICT before surgery.

Area Of Science

  • Oncology
  • Nuclear Medicine
  • Radiology

Background

  • Neoadjuvant immunochemotherapy (NICT) offers therapeutic benefits for locally advanced gastric cancer (LAGC).
  • Accurate prediction of pathological response to NICT is crucial for treatment optimization in LAGC patients.
  • Utilizing baseline and post-treatment 18F-FDG PET/CT metabolic parameters can aid in predicting treatment outcomes.

Purpose Of The Study

  • To correlate metabolic parameters from baseline and post-treatment 18F-FDG PET/CT scans with the pathological response to NICT in LAGC.
  • To identify imaging biomarkers that can predict tumor regression grade (TRG) after NICT.
  • To evaluate the potential of 18F-FDG PET/CT in guiding surgical decisions for LAGC patients undergoing NICT.

Main Methods

  • Thirty-six LAGC patients receiving NICT (sintilimab and CapeOx) followed by surgery were included.
  • Baseline (bPET) and post-treatment (pPET) 18F-FDG PET/CT scans were analyzed for metabolic parameters: SUVmax, MTV, and TLG.
  • Correlations between metabolic parameters (bSUVmax, pSUVmax, bMTV, pMTV, bTLG, pTLG, ΔSUVmax, ΔMTV, ΔTLG) and pathological response (TRG) were assessed using univariate and ROC analyses.

Main Results

  • Post-treatment MTV (pMTV) and TLG (pTLG) were significantly lower in patients with a good response (GR) compared to poor response (PR).
  • Specific cutoff values for pMTV (1.68 cm³) and pTLG (4.71 cm³) showed moderate accuracy in differentiating GR from PR.
  • Baseline and changes in metabolic parameters (bSUVmax, bMTV, bTLG, ΔSUVmax, ΔMTV, ΔTLG) effectively predicted TRG 0, demonstrating high sensitivity and specificity.

Conclusions

  • Combined baseline and post-treatment 18F-FDG PET/CT imaging biomarkers show significant potential for predicting pathological response to NICT in LAGC.
  • These imaging metrics can assist clinicians in assessing treatment efficacy and tailoring surgical strategies for LAGC patients.
  • 18F-FDG PET/CT serves as a valuable non-invasive tool for evaluating treatment response in LAGC undergoing neoadjuvant therapy.

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