Comparison of PET Metabolic Indices for the Early Assessment of Tumour Response in Metastatic Colorectal Cancer Patients Treated by Polychemotherapy

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2012 Nov 16

PMID 23151911

Citations 18

Authors

Jacques-Antoine Maisonobe

Camilo A Garcia

Hatem Necib

Bruno Vanderlinden

Alain Hendlisz

Patrick Flamen

Irene Buvat

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the performance of eight metabolic indices for the early assessment of tumour response in patients with metastatic colorectal cancer (mCRC) treated with chemotherapy.

Methods: Forty patients with advanced mCRC underwent two FDG PET/CT scans, at baseline and on day 14 after chemotherapy initiation. For each lesion, eight metabolic indices were calculated: four standardized uptake values (SUV) without correction for the partial volume effect (PVE), two SUV with correction for PVE, a metabolic volume (MV) and a total lesion glycolysis (TLG). The relative change in each index between the two scans was calculated for each lesion. Lesions were also classified as responding and nonresponding lesions using the Response Evaluation Criteria In Solid Tumours (RECIST) 1.0 measured by contrast-enhanced CT at baseline and 6-8 weeks after starting therapy. Bland-Altman analyses were performed to compare the various indices. Based on the RECIST classification, ROC analyses were used to determine how accurately the indices predicted lesion response to therapy later seen with RECIST.

Results: RECIST showed 27 responding and 74 nonresponding lesions. Bland-Altman analyses showed that the four SUV indices uncorrected for PVE could not be used interchangeably, nor could the two SUV corrected for PVE. The areas under the ROC curves (AUC) were not significantly different between the SUV indices not corrected for PVE. The mean SUV change in a lesion better predicted lesion response without than with PVE correction. The AUC was significantly higher for SUV uncorrected for PVE than for the MV, but change in MV provided some information regarding the lesion response to therapy (AUC >0.5).

Conclusion: In these mCRC patients, all SUV uncorrected for PVE accurately predicted the tumour response on day 14 after starting therapy as assessed 4 to 6 weeks later (i.e. 6 to 8 weeks after therapy initiation) using the RECIST criteria. Neither correcting SUV for PVE nor measuring TLG improved the assessment of tumour response compared to SUV uncorrected for PVE. The change in MV was the least accurate index for predicting tumour response.

Citing Articles

Performance Analysis of Six Semi-Automated Tumour Delineation Methods on [F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) in Patients with Head and Neck Cancer.

Bianconi F, Salis R, Fravolini M, Khan M, Minestrini M, Filippi L Sensors (Basel). 2023; 23(18).

PMID: 37766009 PMC: 10537871. DOI: 10.3390/s23187952.

Prognostic analysis of curatively resected pancreatic cancer using harmonized positron emission tomography radiomic features.

Watanabe M, Ashida R, Miyakoshi C, Arizono S, Suga T, Kanao S Eur J Hybrid Imaging. 2023; 7(1):5.

PMID: 36872413 PMC: 9986192. DOI: 10.1186/s41824-023-00163-8.

Relationship of FDG PET/CT Textural Features with the Tumor Microenvironment and Recurrence Risks in Patients with Advanced Gastric Cancers.

Ahn H, Song G, Jang S, Lee H, Lee M, Lee J Cancers (Basel). 2022; 14(16).

PMID: 36010928 PMC: 9406203. DOI: 10.3390/cancers14163936.

Different Prognostic Values of Dual-Time-Point FDG PET/CT Imaging Features According to Treatment Modality in Patients with Non-Small Cell Lung Cancer.

Jang S, Lee J, Lee J, Jo I, Lee S Tomography. 2022; 8(2):1066-1078.

PMID: 35448721 PMC: 9028882. DOI: 10.3390/tomography8020087.

Predicting Survival in Patients with Pancreatic Cancer by Integrating Bone Marrow FDG Uptake and Radiomic Features of Primary Tumor in PET/CT.

Lee J, Park S, Ahn H, Lee S, Jang S Cancers (Basel). 2021; 13(14).

PMID: 34298775 PMC: 8304187. DOI: 10.3390/cancers13143563.

References

Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma A . Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 2000; 35(13):1773-82. DOI: 10.1016/s0959-8049(99)00229-4. View

Tixier F, Rest C, Hatt M, Albarghach N, Pradier O, Metges J . Intratumor heterogeneity characterized by textural features on baseline 18F-FDG PET images predicts response to concomitant radiochemotherapy in esophageal cancer. J Nucl Med. 2011; 52(3):369-78. PMC: 3789272. DOI: 10.2967/jnumed.110.082404. View

Teo B, Seo Y, Bacharach S, Carrasquillo J, Libutti S, Shukla H . Partial-volume correction in PET: validation of an iterative postreconstruction method with phantom and patient data. J Nucl Med. 2007; 48(5):802-10. DOI: 10.2967/jnumed.106.035576. View

Benz M, Allen-Auerbach M, Eilber F, Chen H, Dry S, Phelps M . Combined assessment of metabolic and volumetric changes for assessment of tumor response in patients with soft-tissue sarcomas. J Nucl Med. 2008; 49(10):1579-84. PMC: 4068272. DOI: 10.2967/jnumed.108.053694. View

Brix G, Doll J, Bellemann M, Trojan H, Haberkorn U, Schmidlin P . Use of scanner characteristics in iterative image reconstruction for high-resolution positron emission tomography studies of small animals. Eur J Nucl Med. 1997; 24(7):779-86. DOI: 10.1007/BF00879667. View

Kumar A, Kumar R, Seenu V, Gupta S, Chawla M, Malhotra A . The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Eur Radiol. 2009; 19(6):1347-57. DOI: 10.1007/s00330-009-1303-z. View

Weber W, Figlin R . Monitoring cancer treatment with PET/CT: does it make a difference?. J Nucl Med. 2007; 48 Suppl 1:36S-44S. View

Hanley J, McNeil B . The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982; 143(1):29-36. DOI: 10.1148/radiology.143.1.7063747. View

Thomas B, Erlandsson K, Modat M, Thurfjell L, Vandenberghe R, Ourselin S . The importance of appropriate partial volume correction for PET quantification in Alzheimer's disease. Eur J Nucl Med Mol Imaging. 2011; 38(6):1104-19. DOI: 10.1007/s00259-011-1745-9. View

10.

Larson S, Erdi Y, Akhurst T, Mazumdar M, Macapinlac H, Finn R . Tumor Treatment Response Based on Visual and Quantitative Changes in Global Tumor Glycolysis Using PET-FDG Imaging. The Visual Response Score and the Change in Total Lesion Glycolysis. Clin Positron Imaging. 2003; 2(3):159-171. DOI: 10.1016/s1095-0397(99)00016-3. View

11.

Boussion N, Cheze Le Rest C, Hatt M, Visvikis D . Incorporation of wavelet-based denoising in iterative deconvolution for partial volume correction in whole-body PET imaging. Eur J Nucl Med Mol Imaging. 2009; 36(7):1064-75. DOI: 10.1007/s00259-009-1065-5. View

12.

Buvat I, Necib H, Garcia C, Wagner A, Vanderlinden B, Emonts P . Lesion-based detection of early chemosensitivity using serial static FDG PET/CT in metastatic colorectal cancer. Eur J Nucl Med Mol Imaging. 2012; 39(10):1628-34. PMC: 3458195. DOI: 10.1007/s00259-012-2172-2. View

13.

Kessler R, Ellis Jr J, Eden M . Analysis of emission tomographic scan data: limitations imposed by resolution and background. J Comput Assist Tomogr. 1984; 8(3):514-22. DOI: 10.1097/00004728-198406000-00028. View

14.

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

15.

Hatt M, Cheze-Le Rest C, Aboagye E, Kenny L, Rosso L, Turkheimer F . Reproducibility of 18F-FDG and 3'-deoxy-3'-18F-fluorothymidine PET tumor volume measurements. J Nucl Med. 2010; 51(9):1368-76. DOI: 10.2967/jnumed.110.078501. View

16.

Bailey D, Meikle S . A convolution-subtraction scatter correction method for 3D PET. Phys Med Biol. 1994; 39(3):411-24. DOI: 10.1088/0031-9155/39/3/009. View

17.

Tylski P, Stute S, Grotus N, Doyeux K, Hapdey S, Gardin I . Comparative assessment of methods for estimating tumor volume and standardized uptake value in (18)F-FDG PET. J Nucl Med. 2010; 51(2):268-76. DOI: 10.2967/jnumed.109.066241. View

18.

Hoetjes N, van Velden F, Hoekstra O, Hoekstra C, Krak N, Lammertsma A . Partial volume correction strategies for quantitative FDG PET in oncology. Eur J Nucl Med Mol Imaging. 2010; 37(9):1679-87. PMC: 2918791. DOI: 10.1007/s00259-010-1472-7. View

19.

Buckler A, Boellaard R . Standardization of quantitative imaging: the time is right, and 18F-FDG PET/CT is a good place to start. J Nucl Med. 2011; 52(2):171-2. DOI: 10.2967/jnumed.110.081224. View

20.

Wahl R, Jacene H, Kasamon Y, Lodge M . From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50 Suppl 1:122S-50S. PMC: 2755245. DOI: 10.2967/jnumed.108.057307. View