Role of the pretreatment ¹⁸F-fluorodeoxyglucose positron emission tomography maximal standardized uptake value in predicting outcomes of colon liver metastases and that value's association with Beclin-1 expression

Abstract

The current study sought to evaluate the predictive and prognostic performance of the maximum standardized uptake value (SUV max) prior to treatment in 43 patients with colon cancer and unresectable liver metastases. Patients with colon cancer who underwent 18 F-FDG-PET/computed tomography (CT) scans for staging before the start of first-line 5-fluorouracil-based chemotherapy were retrospectively analyzed. Expression of Beclin-1 in cancer cells was evaluated in primary tumors using immunohistochemical staining. The pretreatment SUV max for liver metastases was not able to predict progression-free survival but was significantly associated with poorer overall survival, with a hazard ratio of 2.05 (95 % CI, 1.016-4.155). Moreover, a negative correlation was noted between SUV max and expression of a marker of autophagy-Beclin-1 (rho =-0.42, p = 0.006). This suggests that the pretreatment SUV max in 18 F-FDG PET/CT is a useful tool to help predict survival outcome in patients with colon cancer and unresectable liver metastases and may significantly distinguish between patients with low and high levels of Beclin-1 expression (AUC = 0.809, 95% CI: 0.670-0.948, p = 0.001).

Prognostic modeling for patients with colorectal liver metastases incorporating FDG PET radiomic features

“…The resulting HR, though statistically significant, was only 1.17, while it was 1.81 in our study (Table 1). By contrast, SUVmax was evaluated for both OS and PFS by Dimitrova et al [29] in a study of 43 patients with colon cancer and unresectable liver metastases. SUVmax was not able to predict PFS, though it predicted OS with HR value of 2.05 (while it was 1.48 in our study).…”