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Performance of tumor growth kinetics as an imaging biomarker for response assessment in colorectal liver metastases: correlation with FDG PET

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Abstract

Purpose

To correlate RECIST, volumetric criteria, and tumor growth kinetics at multidetector-computed tomography with tumor metabolic activity at FDG PET in colorectal liver metastases (CRCLM) treated with bevacizumab-based chemotherapy.

Methods

Thirty-two CRCLM in 20 patients treated with bevacizumab-based chemotherapy were evaluated. Pre- and post-treatment CT scans were used to calculate reciprocal of doubling time (RDT), percentage change in the lesion’s longest transaxial diameter (RECIST 1.1), and percentage change in the tumor volume. The accuracy of these parameters in predicting response based on standard uptake value analysis at FDG PET was assessed. Data were analyzed using Spearman’s correlation, student’s t, Mann–Whitney, Wilcoxon signed-rank, and Fisher’s exact tests.

Results

According to FDG PET, 24/32 (75%) lesions were categorized as responders and 8/32 (25%) lesions as nonresponders. Based on RDT, 26/32 (81.25%) lesions were classified as responders and 6/32 (18.75%) lesions as nonresponders. Response classification according to RDT and FDG PET was concordant in 30/32 (93.75%) lesions, whereas RECIST 1.1 and volumetric criteria were concordant with FDG PET for 20/32 (62.5%) and 21/32 (65.63%) lesions, respectively. A strong association was found between RDT and response based on FDG PET (odds ratio = 127.4; 95% CI 5.54–2997; P < 0.0001).

Conclusions

Tumor growth kinetics may be an effective imaging biomarker for response evaluation in CRCLM.

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Abbreviations

WHO:

World Health Organization

RECIST:

Response Evaluation Criteria in Solid Tumors

18F FDG:

18-Fluoro-2-deoxyglucose

PET:

Positron emission tomography

CRCLM:

Colorectal liver metastases

MDCT:

Multidetector-computed tomography

SUV:

Standard uptake value

CR:

Complete response

PR:

Partial response

SD:

Stable disease

PD:

Progressive disease

RDT:

Reciprocal of doubling time

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Acknowledgment

Adeel R. Seyal, Keyur Parekh, and Atilla Arslanoglu received educational Grant from Siemens Healthcare.

Conflict of interest

All other authors had nothing to disclose.

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Authors and Affiliations

  1. Department of Radiology, Northwestern Memorial Hospital, Northwestern University-Feinberg School of Medicine, 676 North Saint Clair Street Suite 800, Chicago, IL, 60611, USA

    Adeel R. Seyal, Keyur Parekh, Atilla Arslanoglu, Fernanda D. Gonzalez-Guindalini, Sandra M. Tochetto, Yuri S. Velichko & Vahid Yaghmai

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  1. Adeel R. Seyal
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  2. Keyur Parekh
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Correspondence to Vahid Yaghmai.

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Seyal, A.R., Parekh, K., Arslanoglu, A. et al. Performance of tumor growth kinetics as an imaging biomarker for response assessment in colorectal liver metastases: correlation with FDG PET. Abdom Imaging 40, 3043–3051 (2015). https://doi.org/10.1007/s00261-015-0546-1

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