Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before 18F-FDG PET can be implemented for response evaluation the repeatability should be known. This study was performed to assess the magnitude of the changes in standardized uptake value (SUV), volume and total lesion glycolysis (TLG) in colorectal liver metastases and validate the biological basis of 18F-FDG PET in colorectal liver metastases.
Twenty patients scheduled for liver metastasectomy underwent two 18F-FDG PET scans within 1 week. Bland-Altman analysis was performed to assess repeatability of SUVmax, SUVmean, volume and TLG. Tumours were delineated using an adaptive threshold method (PETSBR) and a semiautomatic fuzzy locally adaptive Bayesian (FLAB) delineation method.
Coefficient of repeatability of SUVmax and SUVmean were ∼39 and ∼31 %, respectively, independent of the delineation method used and image reconstruction parameters. However, repeatability was worse in recently treated patients. The FLAB delineation method improved the repeatability of the volume and TLG measurements compared to PETSBR, from coefficients of repeatability of over 85 % to 45 % and 57 % for volume and TLG, respectively. Glucose transporter 1 (GLUT1) expression correlated to the SUVmean. Vascularity (CD34 expression) and tumour hypoxia (carbonic anhydrase IX expression) did not correlate with 18F-FDG PET parameters.
In conclusion, repeatability of SUVmean and SUVmax was mainly affected by preceding systemic therapy. The repeatability of tumour volume and TLG could be improved using more advanced and robust delineation approaches such as FLAB, which is recommended when 18F-FDG PET is utilized for volume or TLG measurements. Improvement of repeatability of PET measurements, for instance by dynamic PET scanning protocols, is probably necessary to effectively use PET for early response monitoring.
- Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010;60:277–300. CrossRef
- Tol J, Koopman M, Cats A, Rodenburg CJ, Creemers GJ, Schrama JG, et al. Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer. N Engl J Med 2009;360:563–72. CrossRef
- Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228–47. CrossRef
- Desar IM, van Herpen CM, van Laarhoven HW, Barentsz JO, Oyen WJ, van der Graaf WT, et al. Beyond RECIST: molecular and functional imaging techniques for evaluation of response to targeted therapy. Cancer Treat Rev 2009;35:309–21. CrossRef
- Busk M, Horsman MR, Jakobsen S, Bussink J, van der Kogel A, Overgaard J. Cellular uptake of PET tracers of glucose metabolism and hypoxia and their linkage. Eur J Nucl Med Mol Imaging 2008;35:2294–303. CrossRef
- de Geus-Oei LF, Wiering B, Krabbe PF, Ruers TJ, Punt CJ, Oyen WJ. FDG-PET for prediction of survival of patients with metastatic colorectal carcinoma. Ann Oncol 2006;17:1650–5. CrossRef
- Kunkel M, Reichert TE, Benz P, Lehr HA, Jeong JH, Wieand S, et al. Overexpression of Glut-1 and increased glucose metabolism in tumors are associated with a poor prognosis in patients with oral squamous cell carcinoma. Cancer 2003;97:1015–24. CrossRef
- Warburg O. On the origin of cancer cells. Science 1956;123:309–14. CrossRef
- Ruan K, Song G, Ouyang G. Role of hypoxia in the hallmarks of human cancer. J Cell Biochem 2009;107:1053–62. CrossRef
- Macheda ML, Rogers S, Best JD. Molecular and cellular regulation of glucose transporter (GLUT) proteins in cancer. J Cell Physiol 2005;202:654–62. CrossRef
- de Geus-Oei LF, Vriens D, van Laarhoven HW, Van Der Graaf WT, Oyen WJ. Monitoring and predicting response to therapy with 18F-FDG PET in colorectal cancer: a systematic review. J Nucl Med 2009;50 Suppl 1:43S–54. CrossRef
- Hatt M, Cheze-Le Rest C, Aboagye EO, Kenny LM, Rosso L, Turkheimer FE, et al. Reproducibility of 18F-FDG and 3′-deoxy-3′-18F-fluorothymidine PET tumor volume measurements. J Nucl Med 2010;51:1368–76. doi:10.2967/jnumed.110.078501. CrossRef
- Nahmias C, Wahl LM. Reproducibility of standardized uptake value measurements determined by 18F-FDG PET in malignant tumors. J Nucl Med 2008;49:1804–8. CrossRef
- Weber WA, Ziegler SI, Thödtmann R, Hanauske AR, Schwaiger M. Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med 1999;40:1771–7.
- Velasquez LM, Boellaard R, Kollia G, Hayes W, Hoekstra OS, Lammertsma AA, et al. Repeatability of 18F-FDG PET in a multicenter phase I study of patients with advanced gastrointestinal malignancies. J Nucl Med 2009;50:1646–54. doi:10.2967/jnumed.109.063347. CrossRef
- Jaskowiak CJ, Bianco JA, Perlman SB, Fine JP. Influence of reconstruction iterations on 18F-FDG PET/CT standardized uptake values. J Nucl Med 2005;46:424–8.
- Boellaard R, Oyen WJ, Hoekstra CJ, Hoekstra OS, Visser EP, Willemsen AT, et al. The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials. Eur J Nucl Med Mol Imaging 2008;35:2320–33. doi:10.1007/s00259-008-0874-2. CrossRef
- Lodge MA, Chaudhry MA, Wahl RL. Noise considerations for PET quantification using maximum and peak standardized uptake value. J Nucl Med 2012;53:1041–7. doi:10.2967/jnumed.111.101733. CrossRef
- Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging 2010;37:181–200. CrossRef
- Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med 2009;50 Suppl 1:122S–50. CrossRef
- Hatt M, Cheze le Rest C, Turzo A, Roux C, Visvikis D. A fuzzy locally adaptive Bayesian segmentation approach for volume determination in PET. IEEE Trans Med Imaging 2009;28:881–93. CrossRef
- Hatt M, Cheze le Rest C, Descourt P, Dekker A, De Ruysscher D, Oellers M, et al. Accurate automatic delineation of heterogeneous functional volumes in positron emission tomography for oncology applications. Int J Radiat Oncol Biol Phys 2010;77:301–8. CrossRef
- Rademakers SE, Rijken PF, Peeters WJ, Nijkamp MM, Barber PR, van der Laak J, et al. Parametric mapping of immunohistochemically stained tissue sections; a method to quantify the colocalization of tumor markers. Cell Oncol (Dordr) 2011;34:119–29.
- Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307–10. CrossRef
- Dewitte K, Fierens C, Stöckl D, Thienpont LM. Application of the Bland-Altman plot for interpretation of method-comparison studies: a critical investigation of its practice. Clin Chem 2002;48:799–801.
- van Laarhoven HW, Rijpkema M, Punt CJ, Ruers TJ, Hendriks JC, Barentsz JO, et al. Method for quantitation of dynamic MRI contrast agent uptake in colorectal liver metastases. J Magn Reson Imaging 2003;18:315–20. CrossRef
- de Langen AJ, Vincent A, Velasquez LM, van Tinteren H, Boellaard R, Shankar LK, et al. Repeatability of 18F-FDG uptake measurements in tumors: a metaanalysis. J Nucl Med 2012;53:701–8. doi:10.2967/jnumed.111.095299. CrossRef
- Frings V, de Langen AJ, Smit EF, van Velden FH, Hoekstra OS, van Tinteren H, et al. Repeatability of metabolically active volume measurements with 18F-FDG and 18F-FLT PET in non-small cell lung cancer. J Nucl Med 2010;51:1870–7. doi:10.2967/jnumed.110.077255. CrossRef
- Bos R, van der Hoeven JJ, van der Wall E, van der Groep P, van Diest PJ, Comans EF, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol 2002;20:379–87. CrossRef
- Vordermark D, Kaffer A, Riedl S, Katzer A, Flentje M. Characterization of carbonic anhydrase IX (CA IX) as an endogenous marker of chronic hypoxia in live human tumor cells. Int J Radiat Oncol Biol Phys 2005;61:1197–207. CrossRef
- Rademakers SE, Lok J, van der Kogel AJ, Bussink J, Kaanders JH. Metabolic markers in relation to hypoxia; staining patterns and colocalization of pimonidazole, HIF-1α, CAIX, LDH-5, GLUT-1, MCT1 and MCT4. BMC Cancer 2011;11:167. CrossRef
- Rademakers SE, Span PN, Kaanders JH, Sweep FC, van der Kogel AJ, Bussink J. Molecular aspects of tumour hypoxia. Mol Oncol 2008;2:41–53. CrossRef
- Brown JM. Evidence for acutely hypoxic cells in mouse tumours, and a possible mechanism of reoxygenation. Br J Radiol 1979;52:650–6. CrossRef
- Burgman P, Odonoghue JA, Humm JL, Ling CC. Hypoxia-induced increase in FDG uptake in MCF7 cells. J Nucl Med 2001;42:170–5.
- Clavo AC, Brown RS, Wahl RL. Fluorodeoxyglucose uptake in human cancer cell lines is increased by hypoxia. J Nucl Med 1995;36:1625–32.
- Minn H, Clavo AC, Wahl RL. Influence of hypoxia on tracer accumulation in squamous-cell carcinoma: in vitro evaluation for PET imaging. Nucl Med Biol 1996;23:941–6. CrossRef
- van Laarhoven HW, de Geus-Oei LF, Wiering B, Lok J, Rijpkema M, Kaanders JH, et al. Gadopentetate dimeglumine and FDG uptake in liver metastases of colorectal carcinoma as determined with MR imaging and PET. Radiology 2005;237:181–8. CrossRef
- Bender H, Bangard N, Metten N, Bangard M, Mezger J, Schomburg A, et al. Possible role of FDG-PET in the early prediction of therapy outcome in liver metastases of colorectal cancer. Hybridoma 1999;18:87–91. CrossRef
- 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
Volume 39, Issue 12 , pp 1858-1867
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Colorectal metastases
- 18F-FDG PET
- Industry Sectors
- Author Affiliations
- 1. Department of Medical Oncology 452, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
- 2. Department of Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- 3. Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- 5. INSERM U1101, LaTIM, Brest, France
- 4. Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
- 6. Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands