Metabolic Tumor Volume and Total Lesion Glycolysis on FDG-PET/CT Can Predict Overall Survival After (90)Y Radioembolization of Colorectal Liver Metastases: A Comparison with SUVmax, SUVpeak, and RECIST 1.0

Overview

Journal Eur J Radiol

Specialty Radiology

Date 2016 May 11

PMID 27161074

Citations 29

Authors

Waleed Shady

Sirish Kishore

Somali Gavane

Richard K Do

Joseph R Osborne

Gary A Ulaner

Mithat Gonen

Etay Ziv

Franz E Boas

Constantinos T Sofocleous

Affiliations

Soon will be listed here.

Abstract

Purpose: To compare the performance of 4 metrics of metabolic response on FDG-PET/CT against RECIST 1.0 for determining response and predicting overall survival (OS) following (90)Y resin microspheres radioembolization of colorectal liver metastases (CLM).

Methods: We conducted an IRB-waived retrospective review of our radioembolization database to identify patients with unresectable CLM treated between December 2009 and December 2013. We included patients who had both PET/CT and contrast enhanced CT (CECT) available at baseline and on the first follow-up post-radioembolization. On baseline CECT up to five target tumors were chosen per patient according to RECIST 1.0. Four metrics of FDG-avidity (SUVmax, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG)) on PET/CT were measured for the same target tumors. Using RECIST 1.0, patients were classified as no progression (partial response or stable disease) and progression. For each PET metric, a cut-off point of ≥30% decrease was chosen to define response. OS was calculated from the time of radioembolization using Kaplan-Meier methodology. The log-rank test was used for univariate analysis to identify predictors of OS.

Results: The study enrolled 49 patients with 119 target tumors; a median of 2 (range: 1-5) tumors were selected per patient. Median OS was 12.7 months (95%CI: 7.2-16.7). Response by MTV (P=0.035) and TLG (P=0.044) reached statistical significance in predicting OS. Response by SUVmax (P=0.21), SUVpeak (P=0.20) or no progression by RECIST 1.0 (P=0.44) did not predict OS.

Conclusion: Metabolic response based on changes in MTV and TLG can predict OS post-radioembolization of CLM.

Citing Articles

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Vulasala S, Sutphin P, Kethu S, Onteddu N, Kalva S Front Oncol. 2023; 13:963966.

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