Comparison of PET metabolic indices for the early assessment of tumour response in metastatic colorectal cancer patients treated by polychemotherapyReport as inadecuate




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European Journal of Nuclear Medicine and Molecular Imaging

, Volume 40, Issue2, pp 166174

First Online: 14 November 2012Received: 19 June 2012Accepted: 04 October 2012DOI: 10.1007-s00259-012-2274-x

Cite this article as: Maisonobe, JA., Garcia, C.A., Necib, H. et al. Eur J Nucl Med Mol Imaging 2013 40: 166. doi:10.1007-s00259-012-2274-x

Abstract

PurposeTo compare the performance of eight metabolic indices for the early assessment of tumour response in patients with metastatic colorectal cancer mCRC treated with chemotherapy.

MethodsForty 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 68weeks 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.

ResultsRECIST 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.

ConclusionIn these mCRC patients, all SUV uncorrected for PVE accurately predicted the tumour response on day 14 after starting therapy as assessed 4 to 6weeks later i.e. 6 to 8weeks 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.

KeywordsPartial volume effectTreatment responseSUVClassification performancesFDG PETColorectal cancer Download fulltext PDF



Author: Jacques-AntoineMaisonobe - CamiloA.Garcia - HatemNecib - BrunoVanderlinden - AlainHendlisz - PatrickFlamen - IrneBuvat

Source: https://link.springer.com/



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