The Prognostic Value of SUVmax of 18F-FDG PET/CT in Patients with Metastatic Colorectal Cancer

Abstract

<p><strong>Objective. </strong>The aim of the study was to evaluate the prognostic value of the maximum standardized uptake value (SUVmax) of 18F-Fluorodeoxyglucose (18F-FDG) PET/CT in patients with metastatic colorectal cancer, and to compare it with classical prognostic markers.</p><p><strong>Materials and Methods. </strong>The study included 70 patients with metastatic colorectal cancer who had not been treated for the metastatic disease. The patients underwent 18F-FDG PET/CT as part of their routine diagnostic reevaluation. During the analysis, the value of the largest tumor diameter and SUVmax was determined for the lesion with the highest SUVmax observed. The values of CEA and CA 19-9 were recorded 7 days before the PET/CT analysis.</p><p><strong>Results. </strong>SUVmax and Carbohydrate antigen (CA)19-9 were found to be independent prognostic markers of disease progression within 12 months. Based on the Receiver Operating Characteristics (ROC) curve analysis, the patients could be divided into two groups: SUVmax≤4.1 vs. SUVmax>4.1. Patients with SUVmax values of 4.1 or less had significantly better progression-free survival within 12 months with an HR (95% CI) of 2.97 (1.4-6.3), relative to patients with SUVmax values above 4.1.</p><p><strong>Conclusion. </strong>SUVmax may be used as a novel prognostic marker of disease progression among patients with metastatic colorectal cancer. Values of SUVmax can be used to select patients with a more aggressive type of disease and higher risk for progression within 12 months of PET/CT analysis.</p>

Clinical Significance and Prognostic Value of the Maximum Standardized Uptake Value of 18F-Flurodeoxyglucose Positron Emission Tomography–Computed Tomography in Colorectal Cancer

“…We speculated that the reasons might be that, in addition to the small sample size of each study, the doubtful locoregional disease, such as polyps, and precancerous lesions might affect the 18 but not associated with CA199. Our results failed to show significant correlation between SUVmax and CEA, CA125, CA153, or CA199 levels, which was partly consistent with previously reported data (46).…”

“…Regarding the correlations between SUVmax and tumor biomarkers, Sokolović et al. ( 46 ) found that SUVmax was associated with CEA levels, but not associated with CA199. Our results failed to show significant correlation between SUVmax and CEA, CA125, CA153, or CA199 levels, which was partly consistent with previously reported data ( 46 ).…”

“…Sixteen studies (13,37,(39)(40)(41)(42)(43)(44)(45)(46)(47)(48) with 1,325 patients with CRC that evaluated the prognostic value of the SUVmax in patients with CRC were included in the meta-analysis. The details of included studies are listed in Table 4.…”

“…Two studies provided the survival data from univariate instead of multivariate Cox regression. In order to analyze the prognostic value of the SUVmax in different survival data types, we divided the patients into two groups based on the survival data type, including overall survival (OS) (8,31,32,35,37,40) and disease-free survival (DFS) or progression-free survival (PFS) (37,(40)(41)(42)(43)(44)(45)(46)(47)(48). By combining these data, we found that the SUVmax was not associated with OS of patients with CRC; however, there was significant heterogeneity across the studies (HR: 1.32, 95% CI: 0.88-2.00; Random effect method, I 2 : 66%, p heterogeneity: 0.01; Figure 6A).…”

Prediction value of 18F-FDG PET/CT intratumor metabolic heterogeneity parameters for recurrence after radical surgery of stage II/III colorectal cancer

“…For colorectal cancer, although 18 F-FDG PET/CT is currently not recommended as a routine investigation for initial staging, it is recommended when distant metastasis is suspected. Related studies have also indicated that traditional metabolic parameters have certain values in colorectal cancer (8)(9)(10). In recent years, intratumor metabolic heterogeneity parameters derived from PET/CT, for example, coefficient of variation and MTV-based linear regression slope, have been certified to report the traits of intratumor heterogeneity partly and bring into play in forecasting prognosis in a few entity tumors (11)(12)(13).…”