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FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis
Journal article   Open access   Peer reviewed

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

Shih-Hsin Chen, Kenneth Miles, Stuart A Taylor, Balaji Ganeshan, Manuel Rodriquez, Francesco Fraioli, Simon Wan, Asim Afaq, Robert Shortman, Darren Walls, …
European journal of nuclear medicine and molecular imaging, Vol.49(1), pp.371-384
04/10/2021
DOI: 10.1007/s00259-021-05318-y
PMID: 33837843
url
https://doi.org/10.1007/s00259-021-05318-yView
Published (Version of record) Open Access

Abstract

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. 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. 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. 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.
Colorectal Cancer Metabolism FDG-PET CT perfusion Vascular Survival

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