Abstract
Purpose
The purpose of this study is to evaluate the correlation between KRAS mutation, 18F-FDG uptake, and metastatic pattern in advanced stage colorectal cancer (CRC) patients.
Methods
Medical records of stage IV CRC patients who underwent 18F-FDG PET/CT for staging and KRAS mutation analysis were selected. On PET scans, a volume of interest (VOI) was drawn on the primary lesion. 18F-FDG indices (SUVmax, SUVmean, MTV, TLG) of the primary lesions were obtained and correlated with KRAS mutation of the primary lesion. Also, metastatic sites were recorded. Association between metastatic pattern and KRAS expression and FDG indices were analyzed.
Results
KRAS mutation was positive in 40 (43%) patients. Evaluation of FDG indices showed that higher SUVmax (14.0 vs. 11.2, p = 0.004), higher SUVmean (5.3 vs. 4.7, p = 0.005), and higher TLG (301.4 vs. 205.5, p = 0.023) were predictive of KRAS mutation compared to wild-type (WT) KRAS. Lung metastasis was more frequently involved in patients with KRAS mutation (50.0% vs. 22.6%, p = 0.006), and liver metastasis was more frequently involved in patients with WT KRAS (81.1% vs. 55.0%, p = 0.007). Multivariate analysis showed that primary tumor location (OR 3.92, p = 0.07) and KRAS mutation (OR 2.45, p = 0.09) were significant factors in lung metastasis model.
Conclusion
KRAS mutation patients had more frequent lung metastasis and had higher 18F-FDG uptake compared to WT KRAS in stage IV CRC.
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This research was supported by the Grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A110853).
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
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The institutional review board approved this retrospective study. Informed consent was waived.
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Cho, A., Jo, K., Hwang, S.H. et al. Correlation between KRAS mutation and 18F-FDG uptake in stage IV colorectal cancer. Abdom Radiol 42, 1621–1626 (2017). https://doi.org/10.1007/s00261-017-1054-2
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DOI: https://doi.org/10.1007/s00261-017-1054-2