FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis

Abstract Purpose This study assesses the potential for vascular-metabolic imaging with FluoroDeoxyGlucose (FDG)–Positron Emission Tomography/Computed Tomography (PET/CT) perfusion to provide markers of prognosis specific to the site and stage of colorectal cancer. Methods This prospective observational study comprised of participants with suspected colorectal cancer categorized as either (a) non-metastatic colon cancer (M0colon), (b) non-metastatic rectal cancer (M0rectum), or (c) metastatic colorectal cancer (M+). Combined FDG-PET/CT perfusion imaging was successfully performed in 286 participants (184 males, 102 females, age: 69.60 ± 10 years) deriving vascular and metabolic imaging parameters. Vascular and metabolic imaging parameters alone and in combination were investigated with respect to overall survival. Results A vascular-metabolic signature that was significantly associated with poorer survival was identified for each patient group: M0colon – high Total Lesion Glycolysis (TLG) with increased Permeability Surface Area Product/Blood Flow (PS/BF), Hazard Ratio (HR) 3.472 (95% CI: 1.441–8.333), p = 0.006; M0rectum – high Metabolic Tumour Volume (MTV) with increased PS/BF, HR 4.567 (95% CI: 1.901–10.970), p = 0.001; M+ participants, high MTV with longer Time To Peak (TTP) enhancement, HR 2.421 (95% CI: 1.162–5.045), p = 0.018. In participants with stage 2 colon cancer as well as those with stage 3 rectal cancer, the vascular-metabolic signature could stratify the prognosis of these participants. Conclusion Vascular and metabolic imaging using FDG-PET/CT can be used to synergise prognostic markers. The hazard ratios suggest that the technique may have clinical utility.

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Metabolic Imaging Phenotype Using Radiomics of [18F]FDG PET/CT Associated with Genetic Alterations of Colorectal Cancer

Molecular Imaging and Biology ◽

10.1007/s11307-018-1225-8 ◽

2018 ◽

Vol 21 (1) ◽

pp. 183-190 ◽

Cited By ~ 7

Author(s):

Shang-Wen Chen ◽

Wei-Chih Shen ◽

William Tzu-Liang Chen ◽

Te-Chun Hsieh ◽

Kuo-Yang Yen ◽

...

Keyword(s):

Colorectal Cancer ◽

Fdg Pet ◽

Genetic Alterations ◽

Metabolic Imaging ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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18F FDG PET-CT for EBRT Planning in Inoperable Rectal Carcinoma after Receiving Chemotherapy– A

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i1.35587 ◽

2018 ◽

Vol 19 (1) ◽

pp. 56

Author(s):

Shamim MF Begum ◽

Fatima Begum ◽

Raihan Hossain ◽

Md Abu Bakker Siddique ◽

Khokon Kumar Nath ◽

...

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Radiation Therapy ◽

Fdg Pet ◽

External Beam ◽

Tumor Site ◽

Font Size ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in men and the second in women globally. The incidence varies with geographic difference. In Bangladesh, hospital based cancer registry shows rate of CRC in male 10.1%- 12% and in female 3% - 12.0%. The prognosis of the disease and treatment planning depends upon the staging of the disease. Surgery is usually a common way of treatment of rectal cancer except some cases with advanced stage. Radiation therapy, often with chemotherapy, is frequently used in the adjuvant or neoadjuvant setting for the treatment of rectal cancers. External beam radiation therapy (EBRT) is a well practiced method of treatment in the in-operable cases of rectal cancer. 18F FDG PET-CT is a well recognized imaging tool in the pretreatment evaluation of colorectal cancer worldwide. Accurate staging is needed for proper selection of treatment and cost effectiveness. Here, we discussed a case of rectal cancer (stage IV) with post chemotherapy state with history of palliative loop iliostomy bypass. The patient was referred for 18 F FDG PET-CT scan for restaging of the disease and to localize functioning tumor site for external beam radiotherapy (EBRT) planning. FDG PET-CT imaging revealed FDG avidity at the primary tumor site, perircetal fat and multiple FDG avid hypermetabolic lymphnodes in pelvic cavity. A focal FDG avid lesion in anterior aspect of liver suggests hepatic involvement. The fusion PET-CT imaging has played an important role in the further management of the patient by providing guidelines in EBRT.Bangladesh J. Nuclear Med. 19(1): 56-60, January 2016

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Correction to: FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05546-2 ◽

2021 ◽

Author(s):

Shih-Hsin Chen ◽

Kenneth Miles ◽

Stuart A. Taylor ◽

Balaji Ganeshan ◽

Manuel Rodriquez ◽

...

Keyword(s):

Colorectal Cancer ◽

Fdg Pet ◽

Metabolic Imaging ◽

Pet Ct ◽

Fdg Pet Ct

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Ganzkörper FDG-PET/CT mit integrierter CT-Perfusion zur Charakterisierung von hepatischen Metastasen – initiale Ergebnisse zur technischen Durchführbarkeit

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-2008-1073494 ◽

2008 ◽

Vol 180 (S 1) ◽

Author(s):

PV Veit-Haibach ◽

V Treyer ◽

JD Soyka ◽

K Strobel ◽

M Perez Lage ◽

...

Keyword(s):

Fdg Pet ◽

Ct Perfusion ◽

Pet Ct ◽

Fdg Pet Ct

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Role of 18F-PET-CT to predict pathological response after neoadjuvant treatment of rectal cancer

Discover Oncology ◽

10.1007/s12672-021-00405-w ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Riccardo Caruso ◽

Emilio Vicente ◽

Yolanda Quijano ◽

Hipolito Duran ◽

Isabel Fabra ◽

...

Keyword(s):

Rectal Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Standardized Uptake Value ◽

Tumour Regression Grade ◽

Pet Ct ◽

Significant Difference ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.

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