{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T08:23:27Z","timestamp":1787387007707,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K19348"],"award-info":[{"award-number":["24K19348"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25K19724"],"award-info":[{"award-number":["25K19724"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      Reliable pretreatment biomarkers for predicting resistance to standard chemoradiotherapy (CRT) in locally advanced rectal cancer (LARC) remain lacking. This study evaluated the prognostic value of the tumour area (TA)\u2010to\u2010maximum standardized uptake value (SUVmax) [T\/S] ratio, a novel imaging index derived from magnetic resonance imaging (MRI) and\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010fluorodeoxyglucose positron emission tomography\u2010computed tomography (PET\u2010CT), for predicting oncological outcomes in LARC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We retrospectively analysed 68 patients with LARC who underwent preoperative CRT followed by curative resection between 2013 and 2024. TA was measured on axial T2\u2010weighted MRI, and SUVmax was obtained from PET\u2010CT. The T\/S ratio was calculated as TA\/SUVmax. Receiver operating characteristic analysis determined the optimal cut\u2010off for relapse\u2010free survival (RFS). Cox proportional hazards models identified independent prognostic factors. Immunohistochemical analysis of L\u2010type amino acid transporter 1 (LAT1) was performed in 33 patients without CRT to explore biological relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The T\/S ratio showed superior predictive accuracy for\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      (area under the curve, 0.714) than for\n                      <jats:styled-content style=\"fixed-case\">TA<\/jats:styled-content>\n                      (0.616) and\n                      <jats:styled-content style=\"fixed-case\">SUVmax<\/jats:styled-content>\n                      (0.574). Patients with a high T\/S ratio (cut\u2010off 55.81) demonstrated significantly poorer 3\u2010year\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      (51.8% vs. 84.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Multivariate analysis confirmed high T\/S ratio as an independent\n                      <jats:styled-content style=\"fixed-case\">RFS<\/jats:styled-content>\n                      predictor (\n                      <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\n                      4.59; 95%\n                      <jats:styled-content style=\"fixed-case\">CI:<\/jats:styled-content>\n                      1.27\u201316.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Tumours with high T\/S ratios tended to exhibit elevated\n                      <jats:styled-content style=\"fixed-case\">LAT1<\/jats:styled-content>\n                      expression, potentially reflecting a\n                      <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>\n                      \u2010resistant phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The pretreatment T\/S ratio is a simple, noninvasive biomarker that independently predicts RFS in patients with LARC undergoing CRT. This index may assist in risk stratification and individualized neoadjuvant strategy selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70560","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:32:38Z","timestamp":1784871158000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A simple\n                    <scp>MRI<\/scp>\n                    \/\n                    <scp>PET<\/scp>\n                    \u2010derived index predicts relapse\u2010free survival after neoadjuvant chemoradiotherapy in locally advanced rectal cancer"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0537-512X","authenticated-orcid":false,"given":"Ikuma","family":"Shioi","sequence":"first","affiliation":[{"name":"Department of General Surgical Science Gunma University Graduate School of Medicine  Maebashi Gunma 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