Quantitative MR imaging biomarkers of tumor heterogeneity predict prognosis in metastatic colorectal lesions.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15121-e15121 ◽  
Author(s):  
Dania Daye ◽  
Sophia C. Kamran ◽  
Azadeh Tabari ◽  
Mark Michalski ◽  
Jeffrey W. Clark ◽  
...  

e15121 Background: Intra-tumor heterogeneity is an independent determinant of patient survival outcomes in several tumor subtypes. Spatial variations in tumor enhancement on MRI is a macroscopic imaging marker of tumor heterogeneity. The goal of this study is to evaluate the potential role of MRI-based enhancement heterogeneity measures as predictors of survival in patients with metastatic colorectal cancer. Methods: We retrospectively analyzed T1-weighted contrast-enhanced MRI images of metastatic hepatic lesions in 41 patients (mean age 57.2 ±14.2 years) who were diagnosed with stage IV colorectal cancer between 2007 and 2013. Tumor Kras mutation status and patient survival data for up to 95 months was available for all patients. The largest metastatic hepatic lesion was identified by a radiologist and manually segmented. 14 Haralick texture features were extracted from each lesion. Cox proportional hazards regression analysis was used to assess the association between the enhancement heterogeneity measures and patient survival, with adjustment for Kras mutation status as a potential confounder. Backward stepwise feature selection was performed using p > 0.1 (Wald test) to select for statistically significant features. Results:Mean survival time was 39±3.9 months for the study population (51±4.1 months for Kras-wildtype and 37±5.1 for Kras-mutants). 68% of the patients had left-sided colon cancer; 21% had concurrent pulmonary metastases and 0.5% had concurrent brain metastasis. 61%, 27% and 12% of patients were on Flofox, Folfiri or other chemotherapeutic regimen, respectively. Texture matrix homogeneity (HR > 10; p = 0.016), inverse difference moment (HR < 0.1; p = 0.020), entropy (HR < 0.1; p = 0.033) and standard deviation (HR > 10; p = 0.006) exhibited significant independent association with patient survival. With the exception of entropy, these features maintained significant contribution to survival prediction independent of Kras mutation status. Conclusions: MRI-based quantitativeintra-metastasis heterogeneity measures are associated with patient survival and may add information beyond genetic mutation status to optimize prognosis prediction in metastatic colon cancer.

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2148
Author(s):  
Francesco Ardito ◽  
Francesco Razionale ◽  
Lisa Salvatore ◽  
Tonia Cenci ◽  
Maria Vellone ◽  
...  

If KRAS mutation status of primary colorectal tumor is representative of corresponding colorectal liver metastases (CRLM) mutational pattern, is controversial. Several studies have reported different rates of KRAS discordance, ranging from 4 to 32%. Aim of this study is to assess the incidence of discordance and its impact on overall survival (OS) in a homogenous group of patients. KRAS mutation status was evaluated in 107 patients resected for both primary colorectal tumor and corresponding CRLM at the same institution, between 2007 and 2018. Discordance rate was 15.9%. Its incidence varied according to the time interval between the two mutation analyses (p = 0.025; Pearson correlation = 0.2) and it was significantly higher during the first 6 months from the time of primary tumor evaluation. On multivariable analysis, type of discordance (wild-type in primary tumor, mutation in CRLM) was the strongest predictor of poor OS (p < 0.001). At multivariable logistic regression analysis, the number of CRLM >3 was an independent risk factor for the risk of KRAS discordance associated with the worst prognosis (OR = 4.600; p = 0.047). Results of our study suggested that, in the era of precision medicine, possibility of KRAS discordance should be taken into account within multidisciplinary management of patients with metastatic colorectal cancer.


2013 ◽  
Vol 335 (1) ◽  
pp. 225-231 ◽  
Author(s):  
Francesco Fabbri ◽  
Silvia Carloni ◽  
Wainer Zoli ◽  
Paola Ulivi ◽  
Giulia Gallerani ◽  
...  

2012 ◽  
Vol 107 (5) ◽  
pp. 782-789 ◽  
Author(s):  
N J Samadder ◽  
Robert A Vierkant ◽  
Lori S Tillmans ◽  
Alice H Wang ◽  
Charles F Lynch ◽  
...  

2018 ◽  
Vol 57 (12) ◽  
pp. 1727-1729
Author(s):  
Anne Gulbech Ording ◽  
Buket Öztürk ◽  
Karen-Lise Garm Spindler ◽  
Henrik Toft Sørensen ◽  
Margaret McCusker ◽  
...  

2019 ◽  
Vol Volume 12 ◽  
pp. 2115-2121 ◽  
Author(s):  
Ying Lv ◽  
Xin Wang ◽  
Lerong Liang ◽  
Lei Wang ◽  
Jie Lu

2014 ◽  
Vol 39 (6) ◽  
pp. 1261-1266 ◽  
Author(s):  
Michael H. Rosenthal ◽  
Kyung Won Kim ◽  
Charles S. Fuchs ◽  
Jeffrey A. Meyerhardt ◽  
Nikhil H. Ramaiya

2015 ◽  
Vol 1 (2) ◽  
pp. 43 ◽  
Author(s):  
Yana Feodorova ◽  
Dessislava Tashkova ◽  
Kiril Simitchiev ◽  
Anton Todorov ◽  
Gancho Kostov ◽  
...  

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