Purpose: This study examined the correlations between F-FDG PET/CT results and tumor specimen pathology in patients with rectal cancer.
Methods: Sixty-seven patients with rectal cancer who had received preoperative PET/CT were included in this study. Autosegmentation methods were used to determine the maximum PET/CT-based tumor length (TL), tumor width (TW), and metabolic tumor volume for each patient. The TL and TW values were compared with the maximum pathological length and width of the tumor specimen. To forecast the pathological T and N stages, a receiver operating characteristic curve was created for each parameter to evaluate its predictive ability. Logistic regression analysis was used to identify the predictors of pathology.
Results: The values of 30% of maximum uptake for TL and 40% of maximum uptake for TW provided the best match with the maximum pathological tumor length and width (Pearson r = 0.72, P < 0.001; r = 0.44, P < 0.001, respectively). Metabolic tumor volume with a fixed threshold of 2.5 emerged as an independent factor for predicting the pathological T3 or T4 stage (P = 0.001; odds ratio, 1.81; 95% confidence interval, 1.26-2.60).
Conclusions: Preoperative PET/CT can be used as a supplemental tool in predicting pathological findings for patients with rectal cancer requiring operation.