Akademik Veri Yönetim Sistemi
Nuclear Medicine Communications, cilt.47, sa.4, ss.419-428, 2026 (SCI-Expanded, Scopus)
Purpose – To evaluate the relationships between anatomical, functional, and metabolic parameters and distant metastasis in the primary staging of rectal adenocarcinoma. Methods – Seventy-three patients with rectal adenocarcinoma, who underwent pelvic MRI and whole-body 18F-FDG PET/MRI for staging, were included. Anatomical [T and N stages, extramural venous invasion (EMVI) and circumferential resection margin (CRM) statuses] and functional parameters [apparent diffusion coefficient (ADC)mean (mm²/sn × 10−6)] of primary tumor were recorded from pelvic MRI, and metabolic data (maximum standard uptake value (SUVmax), mean SUV (SUVmean ), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and total lesion quotient (TLQ) were recorded from 18F-FDG PET/MRI. Quantitative parameters combining functional and metabolic data (SUVmax/ADCmean, SUVmean/ADCmean, MTV/ADCmean, TLG/ADCmean, TLQ/ADCmean) were calculated. Distant metastases were recorded via 18F-FDG PET/MRI. To detect lung nodules, supplementary 18F-FDG PET/CT scans of the thorax were utilized. Relationship between these parameters and distant metastasis, and their ability to predict for distant metastatic disease, were statistically evaluated. Results – In the univariate logistic regression analysis, the SUVmax (1.04; 1.0–1.08; P = 0.031), TLG (1.0; 1.0–1.005; P = 0.044), TLG/ADCmean (8.12; 1.04–63.78; P = 0.046), and presence of EMVI (4.13; 1.31–12.98; P = 0.015) (OR; CI; P) were found to predict distant metastasis. In multivariate regression analysis, SUVmax (1.05; 1.0–1.1; P = 0.023) and the presence of EMVI (6.82; 1.64–28.48; P = 0.008) were identified as independent predictors for distant metastatic disease (OR; CI; P). Significant associations were detected between distant lymph node metastasis and T stage and the presence of EMVI, whereas significant associations were detected between the size of distant lymph node metastases and the SUVmax, SUVmean, SUVmax/ADCmean, and SUVmean/ADCmean (P < 0.05). Patients with lung and other organ metastases had significantly greater TLG and TLG/ADCmean values (P < 0.05). Conclusion – 18F-FDG PET/MRI allows obtaining anatomical, functional, and metabolic parameters related to the primary tumor in a single session and has the potential to predict information regarding tumor behavior, including distant metastatic spread.