Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2011 | Original Article

The prognostic value of functional tumor volume and total lesion glycolysis in patients with colorectal cancer liver metastases undergoing ⁹⁰Y selective internal radiation therapy plus chemotherapy

Authors: Seza A. Gulec, Rekha R. Suthar, Tushar C. Barot, Kenneth Pennington

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2011

Abstract

Purpose

Functional tumor volume (FTV) and total lesion glycolysis (TLG) are measures of metabolic activity of tumors determined by fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images. These parameters could potentially have clinical value in response to treatment evaluation and disease prognostication. The objectives of this study were to investigate the relationship between functional tumor parameters (FTV and TLG) and clinical outcomes in patients with colorectal cancer liver metastases (CRCLM) undergoing ⁹⁰Y-resin microsphere selective internal radiation therapy (SIRT) (SIR-Spheres®, Sirtex Medical Limited, Lane Cove, NSW, Australia).

Methods

FDG PET/CT studies of 20 patients with unresectable CRCLM who underwent ⁹⁰Y SIRT under a phase II clinical trial were analyzed. FTV and TLG were calculated using PET VCAR (GE Healthcare, Milwaukee, WI, USA) on pretreatment and 4-week posttreatment scans. The effects of pretreatment and posttreatment functional tumor activity on patient survival were evaluated using Kaplan-Meier survival curves.

Results

The median survival in the study group was 14.8 months (range 2.0–27.7 months). The median survival for patients with pretreatment FTV values of above and below 200 cc were 11.2 and 26.9 months, respectively (p < 0.05). The median survival for patients with 4-week posttreatment FTV values of above and below 30 cc were 10.9 and 26.9 months, respectively (p < 0.05). The median survival for patients with pretreatment TLG values of above and below 600 g were 11.2 and 26.9 months, respectively (p < 0.05). The median survival for patients with 4-week posttreatment TLG values of above and below 100 g were 10.9 and 26.9 months, respectively (p < 0.05).

Conclusion

Pretreatment and posttreatment FTV and TLG showed very strong association with survival. These values can be useful quantitative criteria for patient selection and disease prognostication when ⁹⁰Y SIRT is contemplated in patients with CRCLM.

Ell PJ. The contribution of PET/CT to improved patient management. Br J Radiol 2006;79:32–6.PubMedCrossRef

Kostakoglu L, Agress H Jr, Goldsmith SJ. Clinical role of FDG PET in evaluation of cancer patients. Radiographics 2003;23:315–40, quiz 533.PubMedCrossRef

Gulec SA. A surgical perspective on positron emission tomography. J Surg Oncol 2007;95:443–6.PubMedCrossRef

Erdi YE, Macapinlac H, Rosenzweig KE, Humm JL, Larson SM, Erdi AK, et al. Use of PET to monitor the response of lung cancer to radiation treatment. Eur J Nucl Med 2000;27:861–6.PubMedCrossRef

Larson SM, Erdi Y, Akhurst T, Mazumdar M, Macapinlac HA, Finn RD, et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging. The visual response score and the change in total lesion glycolysis. Clin Positron Imaging 1999;2:159–71.PubMedCrossRef

Gulec SA, Mesoloras G, Stabin M. Dosimetric techniques in 90Y-microsphere therapy of liver cancer: the MIRD equations for dose calculations. J Nucl Med 2006;47:1209–11.PubMed

Fortner JG, Fong Y. Twenty-five-year follow-up for liver resection: the personal series of Dr. Joseph G. Fortner. Ann Surg 2009;250:908–13.PubMedCrossRef

Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, et al. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 2004;240:644–57, discussion 657–8.PubMedCrossRef

Low G, Tho LM, Leen E, Wiebe E, Kakumanu S, McDonald AC, et al. The role of imaging in the pre-operative staging and post-operative follow-up of rectal cancer. Surgeon 2008;6:222–31.PubMedCrossRef

10.

Poeppel TD, Krause BJ, Heusner TA, Boy C, Bockisch A, Antoch G. PET/CT for the staging and follow-up of patients with malignancies. Eur J Radiol 2009;70:382–92.PubMedCrossRef

11.

Guillem JG, Moore HG, Akhurst T, Klimstra DS, Ruo L, Mazumdar M, et al. Sequential preoperative fluorodeoxyglucose-positron emission tomography assessment of response to preoperative chemoradiation: a means for determining longterm outcomes of rectal cancer. J Am Coll Surg 2004;199:1–7.PubMedCrossRef

12.

Riedl CC, Akhurst T, Larson S, Stanziale SF, Tuorto S, Bhargava A, et al. 18F-FDG PET scanning correlates with tissue markers of poor prognosis and predicts mortality for patients after liver resection for colorectal metastases. J Nucl Med 2007;48:771–5.PubMedCrossRef

Title: The prognostic value of functional tumor volume and total lesion glycolysis in patients with colorectal cancer liver metastases undergoing 90Y selective internal radiation therapy plus chemotherapy
Authors: Seza A. Gulec
Rekha R. Suthar
Tushar C. Barot
Kenneth Pennington
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2011
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1758-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The prognostic value of functional tumor volume and total lesion glycolysis in patients with colorectal cancer liver metastases undergoing ⁹⁰Y selective internal radiation therapy plus chemotherapy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2011

[68Ga]NODAGA-RGD for imaging αvβ3 integrin expression

Prognostic value of 18F-FDG PET image-based parameters in oesophageal cancer and impact of tumour delineation methodology

Ventilation/perfusion SPECT in chronic obstructive pulmonary disease: an evaluation by reference to symptoms, spirometric lung function and emphysema, as assessed with HRCT

Success of the postoperative 131I therapy in young Belarusian patients with differentiated thyroid cancer after Chernobyl depends on the radiation absorbed dose to the blood and the thyroglobulin level

EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds

18F-FDG PET/CT imaging of an anti-CTLA-4 antibody-associated autoimmune pancolitis