JOURNAL CLUB: Value of Quantitative FDG PET/CT Volumetric Biomarkers in Recurrent Colorectal Cancer Patient Survival

Marcus, Charles; Wray, Rick Arthur; Taghipour, Mehdi; Marashdeh, Wael; Ahn, Se Jin; Mena, Esther; Subramaniam, Rathan M.

doi:10.2214/ajr.15.15806

Cited by 18 publications

(14 citation statements)

References 23 publications

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“…We investigated the value of SUVmax for the discrimination between the benign and malign conditions. Gade et al 7 found a lower mean SUVmax of 8.6, Marcus et al 26 of 7.3 in recurrent CRC when compared to our mean SUVmax of 12.7. Shamim et al 27 found a significant increase of mean SUVmax in recurrence (11.8 for recurrence versus 3.7 for benign conditions) in a study on 32 patients with CRC.…”

Section: Discussioncontrasting

confidence: 63%

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

et al. 2020

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Background/Aim. Colorectal cancer ranks the third most frequent cancer in the world. Approximately 40% of the disease recurs after surgical resection. Determination of predictive parameters for recurrence may help in stratification of patients and contribute to patient management. There are still very few studies which sought factors to predict the recurrence of colorectal cancer. The aim of this study was to examine the predefined risk factors in metastatic development and evaluate clinical significance of 18Ffluorodeoxyglucose (FDG) uptake. Methods. The study was conducted with 56 patients for whom FDG-PET/CT (FDG-positron emission tomography/computed tomography) was requested for the suspicious recurrence or metastasis by routine conventional screening tests. Thirty three patients in whom recurrence/metastases were established with final histopathologic diagnosis formed the malignant group, and 23 patients with no recurrence/metastases formed the benign group. Risk factors [age, serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (Ca 19-9) levels, the maximum standardized uptake volume (SUVmax), tumor size (TS), CT/magnetic resonance imaging (MRI) findings, sex, primary tumor localization, lymphovascular invasion, perineural invasion (PNI), initial neoadjuvant therapy, lymph node initial metastasis (ILNM) excision, stage, tumor differentiation] were compared between these groups. Results. CEA, Ca 19-9, SUVmax, TS, PNI, ILNM, FDG uptake pattern, pattern of lesions on CT and tumor differentiation were found statistically significant by univariate analysis. After multivariate analysis, SUVmax and ILNM remained as the main risk parameters impacting recurrence/metastases. Mean SUVmax was 7.25 in the benign group, while it was 11.7 in the malignant group (p = 0.019). ILNM was present in 66.5% of patients in the malignant group, and in 30.5% of patients in the benign group (p = 0.015). For an estimated cutoff value of 6.3 and 12.5, respectively on ROC curve, the calculated specificities were 61% and 87%, respectively. Conclusion. ILNM and SU-Vmax are the main risk factors for recurrence of colorectal cancer and the patients with these factors must be followed up carefully. FDG-PET/CT is very sensitive for the detection of recurrence/metastases of colorectal cancer and SU-Vmax appears to improve its specificity.

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Section: Discussioncontrasting

confidence: 63%

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

et al. 2020

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“… 2 found a lower mean SUVmax of 8.6, Marcus et al . 26 7.3 in recurrent CRC when compared to ours (12.7). Shamim et al .…”

Section: Discussionsupporting

confidence: 40%

“…Marcus et al . 26 declared SUVmax and TLG to be higher in patients having bad prognosis. Gade et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

İnce

Okuyucu

Hançerlioğulları

et al. 2017

Radiology and Oncology

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BackgroundNearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC.Patients and methodsWe examined the SUVmax value of lesions on control or restaging 18F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]).ResultsMean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease.ConclusionsAlthough SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18F-FDG-PET/CT.

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“…Most studies have shown that SUVmax in CRC is associated with prognostic assessment. Marcus et al 43 said that SUVmax is higher in patients with poor prognosis in CRC. Unlike SUVs, PET/CT metabolic parameters obtained by measuring high metabolic activity areas of tumors can provide volume and metabolic information for highly metabolized tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of the prognostic value of PD-L1 expression and ¹⁸F-FDG PET/CT metabolic parameters in colorectal cancer

Jiang

Zhang²,

Jiang

et al. 2020

J. Cancer

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Background: It has been rarely reported whether 18 F-fluorodeoxyglucose (18 F-FDG) uptake in colorectal cancer cells is associated with the expression of PD-L1. We performed a clinical pathology study to evaluate PD-L1 expression in patients undergoing surgical resection of colorectal cancer with preoperative 18 F-FDG PET/CT imaging, with the aim of predicting the response of CRC patients to immune checkpoint inhibitors. Material and Methods: A retrospective analysis of patients with CRC who underwent FDG-PET imaging before surgery was performed to measure the parameters of FDG-PET imaging: the maximum standardized uptake value (SUVmax), the metabolic tumor volume (MTV), and the total lesion glycolysis (TLG) were evaluated to determine whether each parameter was associated with clinical pathology. Tumor specimens were subjected to PD-L1 staining by immunohistochemistry. Analysis of whether there is a correlation between PD-L1 expression and 18 F-FDG uptake parameters in CRC. Results: PD-L1 expression level was significantly correlated with SUVmax, MTV3.0 and TLG3.0. Multivariate analysis showed that PD-L1 and TLG3.0 were independent predictors of poor DFS in patients with CRC (P=0.009; P=0.016), PD-L1 expression is closely related to the patient's lesion (TLG3.0) (P＜0.01). Conclusion: The results of this study indicate that there was a significant correlation between PD-L1 expression and TLG3.0 which suggested that FDG-PET could serve as a noninvasive tool to assess the tumor microenvironment and as a predictor of PD-L1 inhibitor activity to determine the optimal therapeutic strategy for CRC. High PD-L1 expression levels and high TLG3.0 are independent risk factors for DFS differences in CRC patients.

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JOURNAL CLUB: Value of Quantitative FDG PET/CT Volumetric Biomarkers in Recurrent Colorectal Cancer Patient Survival

Abstract: SUVmax, MTVtotal, TLGtotal, and integrated score with FDG avidity and total tumor burden provide survival information for patients with biopsy-proven recurrent colorectal cancer.

Cited by 18 publications

References 23 publications

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

Retrospective analysis of the prognostic value of PD-L1 expression and ¹⁸F-FDG PET/CT metabolic parameters in colorectal cancer

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JOURNAL CLUB: Value of Quantitative FDG PET/CT Volumetric Biomarkers in Recurrent Colorectal Cancer Patient Survival

Abstract: SUVmax, MTVtotal, TLGtotal, and integrated score with FDG avidity and total tumor burden provide survival information for patients with biopsy-proven recurrent colorectal cancer.

Cited by 18 publications

References 23 publications

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

Prognostic parameters in recurrent colorectal cancer: A role of control or restaging by FDG-PET/CT

Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

Retrospective analysis of the prognostic value of PD-L1 expression and 18F-FDG PET/CT metabolic parameters in colorectal cancer

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Retrospective analysis of the prognostic value of PD-L1 expression and ¹⁸F-FDG PET/CT metabolic parameters in colorectal cancer