Metabolic tumor volume and total lesion glycolysis on FDG-PET/CT can predict overall survival after 90Y radioembolization of colorectal liver metastases: A comparison with SUVmax, SUVpeak, and RECIST 1.0

Waleed Shady, Sirish Kishore, Somali Gavane, Richard K. Do, Joseph R. Osborne, Gary A. Ulaner, Mithat Gonen, Etay Ziv, Franz E. Boas, Constantinos T. Sofocleous

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Purpose: To compare the performance of 4 metrics of metabolic response on FDG-PET/CT against RECIST 1.0 for determining response and predicting overall survival (OS) following 90Y resin microspheres radioembolization of colorectal liver metastases (CLM). Methods: We conducted an IRB-waived retrospective review of our radioembolization database to identify patients with unresectable CLM treated between December 2009 and December 2013. We included patients who had both PET/CT and contrast enhanced CT (CECT) available at baseline and on the first follow-up post-radioembolization. On baseline CECT up to five target tumors were chosen per patient according to RECIST 1.0. Four metrics of FDG-avidity (SUVmax, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG)) on PET/CT were measured for the same target tumors. Using RECIST 1.0, patients were classified as no progression (partial response or stable disease) and progression. For each PET metric, a cut-off point of ≥30% decrease was chosen to define response. OS was calculated from the time of radioembolization using Kaplan-Meier methodology. The log-rank test was used for univariate analysis to identify predictors of OS. Results: The study enrolled 49 patients with 119 target tumors; a median of 2 (range: 1-5) tumors were selected per patient. Median OS was 12.7 months (95%CI: 7.2-16.7). Response by MTV (P = 0.035) and TLG (P = 0.044) reached statistical significance in predicting OS. Response by SUVmax (P = 0.21), SUVpeak (P = 0.20) or no progression by RECIST 1.0 (P = 0.44) did not predict OS. Conclusion: Metabolic response based on changes in MTV and TLG can predict OS post-radioembolization of CLM.

Original languageEnglish
Pages (from-to)1224-1231
Number of pages8
JournalEuropean Journal of Radiology
Volume85
Issue number6
DOIs
StatePublished - 1 Jun 2016
Externally publishedYes

Keywords

  • Colorectal liver metastases
  • Overall survival
  • PET/CT
  • RECIST 1.0
  • Radioembolization

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