Association Between Microsatellite Instability and 18F-FDG PET/CT Data in Colorectal Cancer Patients

Abstract Aim: Our aim in this study was to evaluate the relationship between microsatellite instability (MSI) status and 18F-FDG PET/CT data in patients with colorectal cancer.Materials and Methods: Our study included 74 patients who underwent PET/CT in preoperative staging with the diagnosis of colorectal cancer and then underwent surgical resection. In the immunohistochemical examination, nuclear staining was considered positive for all antibodies. Normal colon mucosa and lymphocytes in tissue were used as an internal positive control group. The absence of nuclear staining in tumor cells was considered "loss" in "Mismatch Repair Gen" proteins. MSI status of patients was divided into 3 groups according to the occurrence of MLH1, PMS2, MSH2, MSH6 gene proteins, and also the number of MSI genes. It is defined as a high frequency of microsatellite instability (MSI-H) when two or more of the five markers in the tumor DNA were positive. If only one marker was positive, the tumor is termed as low frequency of MSI (MSI-L). And MSS is determined when all of the five markers were negative. Results: While MSI was not detected in 56 of the patients (75.7%), MSI was detected in 18 patients (24.3%). 4 patients (5.4%) had MSH-L, while 14 patients (18.9%) had MSH-H. In the analysis made considering all 3 groups, there was no statistically significant relationship between MSI status and SUVmax (p=0.835). Liver metastases were present in 11 (36.7%) of 30 patients who were metastatic at the time of diagnosis. Distant metastasis incidence was lower in 18F-FDG PET/CT in patients with MSI-H (p=0.010). In addition, a significant correlation was found between the presence of liver metastases and MSI, and liver metastasis was not observed in any of the 14 patients with MSI-H (p=0.041).Conclusion: Although not statistically significant, SUVmax values were found to be higher in patients with MSI-H. In addition, metastasis rates were found to be lower in patients with microsatellite instability in accordance with the literature data.

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Impact of 18F-FDG PET/CT on therapeutic decisions in patients with colorectal cancer and liver metastases

Clinical Imaging ◽

10.1016/j.clinimag.2012.09.011 ◽

2013 ◽

Vol 37 (3) ◽

pp. 536-541 ◽

Cited By ~ 13

Author(s):

Alexandros Georgakopoulos ◽

Nikoletta Pianou ◽

Nikolaos Kelekis ◽

Sofia Chatziioannou

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Fdg Pet ◽

Therapeutic Decisions ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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The added value of dual-time-point 18F-FDG PET/CT imaging in the diagnosis of colorectal cancer liver metastases

Abdominal Radiology ◽

10.1007/s00261-019-02396-3 ◽

2020 ◽

Vol 45 (4) ◽

pp. 1075-1081

Author(s):

Wujian Mao ◽

Jun Zhou ◽

Lin Qiu ◽

Hongyan Yin ◽

Hui Tan ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Fdg Pet ◽

Ct Imaging ◽

Added Value ◽

Colorectal Cancer Liver Metastases ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Time Point

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Contrast-enhanced FDG-PET/CT vs. spio-enhanced MRI vs. FDG-PET vs. CT in patients with liver metastases from colorectal cancer: a prospective study with intraoperative confirmation

Acta Radiologica ◽

10.1080/02841850701294560 ◽

2007 ◽

Vol 48 (4) ◽

pp. 369-378 ◽

Cited By ~ 94

Author(s):

E. D. Rappeport ◽

A. Loft ◽

A. K. Berthelsen ◽

P. von der Recke ◽

P. Noergaard Larsen ◽

...

Keyword(s):

Colorectal Cancer ◽

Prospective Study ◽

Liver Metastases ◽

Fdg Pet ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Pet Ct ◽

A Prospective Study ◽

Fdg Pet Ct

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Conversion from unresectable to resectable liver metastases in real-world patients with liver-only metastatic colorectal cancer (mCRC) treated with FOLFOXIRI plus bevacizumab: The Conversion trial.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.tps147 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. TPS147-TPS147

Author(s):

Shahid Ahmed ◽

Deborah Anderson ◽

Haji I. Chalchal ◽

Lynn Dwernychuk ◽

Dilip Gill ◽

...

Keyword(s):

Colorectal Cancer ◽

Cost Effectiveness ◽

Liver Metastases ◽

Real World ◽

Fdg Pet ◽

Conversion Rate ◽

Curative Surgery ◽

Number Of Patients ◽

Pet Ct ◽

Fdg Pet Ct

TPS147 Background: Patients with mCRC generally have a limited life expectancy, however, a small number of patients with liver-only mCRC could be cured following metastasectomy. In highly selected patients with mCRC, FOLFOXIRI (5FU, oxaliplatin, and irinotecan) plus bev results in high response rates. However, very limited evidence is available about efficacy of this regimen in real-world patients with liver-only mCRC. Furthermore, there is paucity of biomarkers that predict liver metastasectomy in such patients. The current study aims a) to evaluate rate of conversion from unresectable to resectable liver metastases in real-world patients with liver-only mCRC following FOLFOXIRI-bev, b) to identify predictive markers including an early PET-FDG response that correlate with curative surgery, & c) to determine disease control rate, overall survival, quality of life, treatment toxicities, and cost-effectiveness of surgery. Methods: In this pragmatic phase 2 study, 37 patients with liver-only unresectable mCRC who are deemed eligible for FOLFOXIRI-bev by their oncologist will be recruited at the two major cancer centers in Saskatchewan. Patients will receive FOLFOXIRI-bev every two weeks for a total of 12 cycles and will undergo periodic imaging tests. The resectability of liver metastases will be determined by a multidisciplinary team. For those patients who are not able to undergo a curative surgery, a doublet chemotherapy regimen ±bev will be continued at the discretion of treating oncologist. . The prognostic and predictive value of mutations in specific genes involved in cell proliferation, cell death resistance, angiogenesis, and invasion in colorectal cancer along with the relationship between the abundance and characteristics of exRNA and conversion rate and survival will be assessed. Logistic regression and Cox proportional analyses will be performed to assess correlation between an eight-week FDG-PET/CT response to chemotherapy and other biomarkers and rate of removal of metastases and survival, respectively. This pragmatic study will help to determine conversion rate in real-world patients with FOLFOXIRI plus bev and role of early FDG-PET/CT scan response and other biomarkers in predicting metastasectomy along with cost-effectiveness of this approach. Clinical trial information: NCT03401294.

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Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-012-2233-6 ◽

2012 ◽

Vol 39 (12) ◽

pp. 1858-1867 ◽

Cited By ~ 18

Author(s):

Linda Heijmen ◽

Lioe-Fee de Geus-Oei ◽

Johannes H. W. de Wilt ◽

Dimitris Visvikis ◽

Mathieu Hatt ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Fdg Pet ◽

Activity Concentration ◽

Pet Ct ◽

18F Fdg ◽

Functional Volume ◽

Fdg Pet Ct

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Imaging of colorectal cancer liver metastases using contrast-enhanced US, multidetector CT, MRI, and FDG PET/CT: a meta-analysis

Acta Radiologica ◽

10.1177/0284185120925481 ◽

2020 ◽

pp. 028418512092548 ◽

Cited By ~ 1

Author(s):

Athina C Tsili ◽

George Alexiou ◽

Christina Naka ◽

Maria I Argyropoulou

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Sensitivity And Specificity ◽

Fdg Pet ◽

Colorectal Cancer Liver Metastases ◽

Contrast Enhanced ◽

Pubmed Database ◽

Pet Ct ◽

Fdg Pet Ct ◽

Prospective Study Design

Background Imaging of colorectal cancer liver metastases (CRCLMs) has improved in recent years. Therefore, the role of current imaging techniques needs to be defined. Purpose To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS), multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT in the detection of CRCLMs. Material and Methods PubMed database was searched for articles published during 2000–2019. Inclusion criteria were as follows: diagnosis/suspicion of CRCLMs; CEUS, MDCT, MRI, or FDG PET/CT performed for the detection of CRCLMs; prospective study design; histopathologic examination, intraoperative findings and/or follow-up used as reference standard; and data for calculating sensitivity and specificity reported. Results Twelve prospective studies were assessed, including 536 patients with CRCLMs (n = 1335). On a per-lesion basis, the sensitivity of CEUS, MDCT, MRI, and FDG PET/CT was 86%, 84%, 89%, and 62%, respectively. MRI had the highest sensitivity on a per-lesion analysis. CEUS and MDCT had comparable sensitivities. On a per-patient basis, the sensitivity and specificity of CEUS, MDCT, MRI, and FDG PET/CT was 80% and 97%, 87% and 95%, 87% and 94%, and 96% and 97%, respectively. The per-patient sensitivities for MRI and MDCT were similar. The sensitivity for MRI was higher than that for CEUS, MDCT, and FDG PET/CT for lesions <10 mm and lesions at least 10 mm in size. Hepatospecific contrast agent did not improve diagnostic performances. Conclusion MRI is the preferred imaging modality for evaluating CRCLMs. Both MDCT and CEUS can be used as alternatives.

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Clinical significance of18F-FDG PET/CT in colorectal carcinoma

Orvosi Hetilap ◽

10.1556/oh.2013.29700 ◽

2013 ◽

Vol 154 (37) ◽

pp. 1447-1453 ◽

Cited By ~ 1

Author(s):

Zsuzsanna Németh ◽

Katalin Boér ◽

Miklós Kásler ◽

Katalin Borbély

Keyword(s):

Colorectal Cancer ◽

Fdg Pet ◽

Imaging Techniques ◽

Preoperative Staging ◽

Diagnostic Procedures ◽

Response To Therapy ◽

Solid Tumours ◽

Early Assessment ◽

Pet Ct ◽

Fdg Pet Ct

Modern imaging techniques have an important role in the diagnostic procedures of malignancies, and assessing response to therapy. The18F-FDG PET/CT revolutionized the evaluation of colorectal cancer in terms of preoperative staging and monitoring of recurrence. Conventional imaging techniques have limitations in early assessment of response to therapy.18F-FDG PET has been shown to allow earlier treatment monitoring, because the metabolic change appears before any anatomic change occurs. The Response Evaluation Criteria in Solid Tumours (RECIST) are widely applied, but they have some limitations. There are new international guidelines for treatment response assessment using PET/CT in solid tumours. The authors review indications and the role of hybrid PET/CT in colorectal cancer. Orv. Hetil., 2013, 154, 1447–1453.

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