The Role of Routine Clinical Pretreatment 18F-FDG PET/CT in Predicting Outcome of Colorectal Liver Metastasis

Tam, Henry; Cook, Gary; Chau, Ian; Drake, Brent; Zerizer, Imene; Du, Yong; Cunningham, David; Koh, Dow‐Mu; Chua, Sue

doi:10.1097/rlu.0000000000000744

Cited by 17 publications

(9 citation statements)

References 24 publications

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“…We had to use Engauge Digitizer to extract data from survival curves, which may result in certain inaccuracy. Nevertheless, the validity of the major findings in this study has been supported by more recent clinical studies [ 38 , 39 ].…”

Section: Discussionsupporting

confidence: 80%

Prognostic significance of 18FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis

Xin

et al. 2015

cancer imaging

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BackgroundThe role of 18-fluorodeoxyglucose positron emission tomography CT (18FDG PET/CT), as a prognostic factor for survival in colorectal cancer patients with liver metastases, is still controversial. We sought to perform a meta-analysis of the literature to address this issue.MethodsA systematic literature search was performed to identify the studies that associated 18FDG PET/CT to clinical survival outcomes of patients with liver metastases. Methodological qualities of the included studies were also assessed. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails.ResultsBy analyzing a total of 867 patients from 15 studies, we found that PET/CT for metabolic response to the therapy was capable of predicting event-free survival (EFS) and overall survival (OS) with statistical significance, and the HR was 0.45 (95 % confidence interval [CI], 0.26–0.78) and 0.36 (95 % CI, 0.18–0.71), respectively. Furthermore, pre-treatment 18FDG PET/CT with high standardized uptake value (SUV) was also significantly associated with poorer OS HR, 1.24; (95 % CI, 1.06–1.45). However, we did not find a statistically significant effect of post-treatment SUV for predicting OS HR, 1.68; (95 % CI, 0.63–4.52).ConclusionsThe present meta-analysis confirms that 18FDG PET/CT is a useful tool to help predict survival outcomes in patients with liver metastases.Electronic supplementary materialThe online version of this article (doi:10.1186/s40644-015-0055-z) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 80%

Prognostic significance of 18FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis

Xin

et al. 2015

cancer imaging

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“…Lee et al have also proposed a prognosis scoring system using the SUV of the primary lesion and liver metastases, as well as tumor number and tumor size. Similar to our findings, Tam et al retrospectively determined that an SUV of ≥6.59 was associated with poor RFS.…”

Section: Discussionsupporting

confidence: 90%

A new strategy based on fluorodeoxyglucose‐positron emission tomography for managing liver metastasis from colorectal cancer

Watanabe

Harimoto

Araki

et al. 2018

Journal of Surgical Oncology

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Background Prognostic models are needed to manage liver metastasis from colorectal cancer (CRLM). Thus, we developed an algorithm to guide treatment based on the standardized uptake value (SUV) from fluorodeoxyglucose‐positron emission tomography (FDG‐PET). Methods We retrospectively evaluated 148 patients who underwent surgery for CRLM, including 107 cases of primary surgery and 41 cases with preoperative chemotherapy before conversion surgery. We evaluated the prognostic value of perioperative SUV among primary surgery cases, as well as the prognostic value of the SUV change ratio after conversion surgery (postchemotherapy/prechemotherapy SUV). Results In the primary surgery group, recurrence‐free survival (RFS) was independently predicted by an SUV of ≥6.04 (P = 0.042) and ≥4 liver metastases ( P = 0.003). The combination of an SUV of ≥6.04 and ≥4 liver metastases was strongly associated with poor RFS ( P < 0.001). In the conversion surgery group, the SUV change ratio was associated with tumor size change and pathological response. An SUV change ratio of ≥0.293 was associated with shorter RFS ( P = 0.006) and independently predicted RFS ( P = 0.026). We established a therapeutic algorithm for managing CRLM based on these results. Conclusion FDG‐PET may be useful for predicting recurrence and prognosis in cases of CRLM, and our algorithm may be useful for managing multiple CRLMs.

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“…Standard uptake values (SUV) and volume-based indices are most extensively investigated. In patients with colorectal cancer, these measures are demonstrated to be prognostic on pre-treatment [ 18 F]FDG PET in neoadjuvant [ 2 , 3 ] and metastatic settings [ 4 , 5 ]. However, the corrected tumour activity or metabolically active tumour volume (MATV) are only some of the PET characteristics which can be calculated from PET images.…”

Section: Introductionmentioning

confidence: 99%

Radiomics analysis of pre-treatment [18F]FDG PET/CT for patients with metastatic colorectal cancer undergoing palliative systemic treatment

Helden

Vacher

Wieringen

et al. 2018

Eur J Nucl Med Mol Imaging

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BackgroundThe aim of this study was to assess radiomics features on pre-treatment [18F]FDG positron emission tomography (PET) as potential biomarkers for response and survival in patients with metastatic colorectal cancer (mCRC).MethodsPatients with mCRC underwent [18F]FDG PET/computed tomography (CT) prior to first- or third-line palliative systemic treatment. Tumour lesions were semiautomatically delineated and standard uptake value (SUV), metabolically active tumour volume (MATV), total lesion glycolysis (TLG), entropy, area under the curve of the cumulative SUV-volume histogram (AUC-CSH), compactness and sphericity were obtained.ResultsLesions of 47 patients receiving third-line systemic treatment had higher SUVmax, SUVpeak, SUVmean, MATV and TLG, and lower AUC-CSH, compactness and sphericity compared to 52 patients receiving first-line systemic treatment. Therefore, first- and third-line groups were evaluated separately. In the first-line group, anatomical changes on CT correlated negatively with TLG (ρ = 0.31) and MATV (ρ = 0.36), and positively with compactness (ρ = −0.27) and sphericity (ρ = −0.27). Patients without benefit had higher mean entropy (p = 0.021). Progression-free survival (PFS) and overall survival (OS) were worse with a decreased mean AUC [hazard ratio (HR) 0.86, HR 0.77] and increase in mean MATV (HR 1.15, HR 1.22), sum MATV (HR 1.14, HR 1.19), mean TLG (HR 1.16, HR 1.22) and sum TLG (HT1.12, HR1.18). In the third-line group, AUC-CSH correlated negatively with anatomical change (ρ = 0.21). PFS and OS were worse with an increased mean MATV (HR 1.27, HR 1.68), sum MATV (HR 1.35, HR 2.04), mean TLG (HR 1.29, HR 1.52) and sum TLG (HT 1.27, HR 1.80). SUVmax and SUVpeak negatively correlated with OS (HR 1.19, HR 1.21). Cluster analysis of the 10 radiomics features demonstrated no complementary value in identifying aggressively growing lesions or patients with impaired survival.ConclusionWe demonstrated an association between improved clinical outcome and pre-treatment low tumour volume and heterogeneity as well as high sphericity on [18F]FDG PET. Future PET imaging research should include radiomics features that incorporate tumour volume and heterogeneity when correlating PET data with clinical outcome.Electronic supplementary materialThe online version of this article (10.1007/s00259-018-4100-6) contains supplementary material, which is available to authorized users.

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The Role of Routine Clinical Pretreatment 18F-FDG PET/CT in Predicting Outcome of Colorectal Liver Metastasis

Abstract: SUV-based metabolic parameters derived from pretreatment F-FDG PET/CT can predict PFS in colorectal liver metastases.

Cited by 17 publications

References 24 publications

Prognostic significance of 18FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis

Prognostic significance of 18FDG PET/CT in colorectal cancer patients with liver metastases: a meta-analysis

A new strategy based on fluorodeoxyglucose‐positron emission tomography for managing liver metastasis from colorectal cancer

Radiomics analysis of pre-treatment [18F]FDG PET/CT for patients with metastatic colorectal cancer undergoing palliative systemic treatment

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