FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis

Shih hsin Chen; Kenneth Miles; Stuart A. Taylor; Balaji Ganeshan; Manuel Rodriquez; Francesco Fraioli; Simon Wan; Asim Afaq; Robert Shortman; Darren Walls; Luke Hoy; Raymond Endozo; Aman Bhargava; Matthew Hanson; Joseph Huang; Sherif Raouf; Daren Francis; Shahab Siddiqi; Tan Arulampalam; Bruce Sizer; Michael Machesney; Nicholas Reay-Jones; Sanjay Dindyal; Tony Ng; Ashley Groves

doi:10.1007/s00259-021-05318-y

FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis

Shih hsin Chen, Kenneth Miles, Stuart A. Taylor, Balaji Ganeshan, Manuel Rodriquez, Francesco Fraioli, Simon Wan, Asim Afaq, Robert Shortman, Darren Walls, Luke Hoy, Raymond Endozo, Aman Bhargava, Matthew Hanson, Joseph Huang, Sherif Raouf, Daren Francis, Shahab Siddiqi, Tan Arulampalam, Bruce SizerMichael Machesney, Nicholas Reay-Jones, Sanjay Dindyal, Tony Ng, Ashley Groves^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Purpose: This study assesses the potential for vascular-metabolic imaging with FluoroDeoxyGlucose (FDG)–Positron Emission Tomography/Computed Tomography (PET/CT) perfusion to provide markers of prognosis specific to the site and stage of colorectal cancer. Methods: This prospective observational study comprised of participants with suspected colorectal cancer categorized as either (a) non-metastatic colon cancer (M0colon), (b) non-metastatic rectal cancer (M0rectum), or (c) metastatic colorectal cancer (M+). Combined FDG-PET/CT perfusion imaging was successfully performed in 286 participants (184 males, 102 females, age: 69.60 ± 10 years) deriving vascular and metabolic imaging parameters. Vascular and metabolic imaging parameters alone and in combination were investigated with respect to overall survival. Results: A vascular-metabolic signature that was significantly associated with poorer survival was identified for each patient group: M0colon – high Total Lesion Glycolysis (TLG) with increased Permeability Surface Area Product/Blood Flow (PS/BF), Hazard Ratio (HR) 3.472 (95% CI: 1.441–8.333), p = 0.006; M0rectum – high Metabolic Tumour Volume (MTV) with increased PS/BF, HR 4.567 (95% CI: 1.901–10.970), p = 0.001; M+ participants, high MTV with longer Time To Peak (TTP) enhancement, HR 2.421 (95% CI: 1.162–5.045), p = 0.018. In participants with stage 2 colon cancer as well as those with stage 3 rectal cancer, the vascular-metabolic signature could stratify the prognosis of these participants. Conclusion: Vascular and metabolic imaging using FDG-PET/CT can be used to synergise prognostic markers. The hazard ratios suggest that the technique may have clinical utility.

Original language	English
Pages (from-to)	371-384
Number of pages	14
Journal	European Journal of Nuclear Medicine and Molecular Imaging
Volume	49
Issue number	1
Early online date	10 Apr 2021
DOIs	https://doi.org/10.1007/s00259-021-05318-y
Publication status	Published - Dec 2021

Keywords

Colorectal cancer
CT perfusion
FDG-PET
Metabolism
Survival
Vascular

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00259-021-05318-y

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Chen, S. H., Miles, K., Taylor, S. A., Ganeshan, B., Rodriquez, M., Fraioli, F., Wan, S., Afaq, A., Shortman, R., Walls, D., Hoy, L., Endozo, R., Bhargava, A., Hanson, M., Huang, J., Raouf, S., Francis, D., Siddiqi, S., Arulampalam, T., ... Groves, A. (2021). FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis. European Journal of Nuclear Medicine and Molecular Imaging, 49(1), 371-384. https://doi.org/10.1007/s00259-021-05318-y

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title = "FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis",

abstract = "Purpose: This study assesses the potential for vascular-metabolic imaging with FluoroDeoxyGlucose (FDG)–Positron Emission Tomography/Computed Tomography (PET/CT) perfusion to provide markers of prognosis specific to the site and stage of colorectal cancer. Methods: This prospective observational study comprised of participants with suspected colorectal cancer categorized as either (a) non-metastatic colon cancer (M0colon), (b) non-metastatic rectal cancer (M0rectum), or (c) metastatic colorectal cancer (M+). Combined FDG-PET/CT perfusion imaging was successfully performed in 286 participants (184 males, 102 females, age: 69.60 ± 10 years) deriving vascular and metabolic imaging parameters. Vascular and metabolic imaging parameters alone and in combination were investigated with respect to overall survival. Results: A vascular-metabolic signature that was significantly associated with poorer survival was identified for each patient group: M0colon – high Total Lesion Glycolysis (TLG) with increased Permeability Surface Area Product/Blood Flow (PS/BF), Hazard Ratio (HR) 3.472 (95% CI: 1.441–8.333), p = 0.006; M0rectum – high Metabolic Tumour Volume (MTV) with increased PS/BF, HR 4.567 (95% CI: 1.901–10.970), p = 0.001; M+ participants, high MTV with longer Time To Peak (TTP) enhancement, HR 2.421 (95% CI: 1.162–5.045), p = 0.018. In participants with stage 2 colon cancer as well as those with stage 3 rectal cancer, the vascular-metabolic signature could stratify the prognosis of these participants. Conclusion: Vascular and metabolic imaging using FDG-PET/CT can be used to synergise prognostic markers. The hazard ratios suggest that the technique may have clinical utility.",

keywords = "Colorectal cancer, CT perfusion, FDG-PET, Metabolism, Survival, Vascular",

author = "Chen, {Shih hsin} and Kenneth Miles and Taylor, {Stuart A.} and Balaji Ganeshan and Manuel Rodriquez and Francesco Fraioli and Simon Wan and Asim Afaq and Robert Shortman and Darren Walls and Luke Hoy and Raymond Endozo and Aman Bhargava and Matthew Hanson and Joseph Huang and Sherif Raouf and Daren Francis and Shahab Siddiqi and Tan Arulampalam and Bruce Sizer and Michael Machesney and Nicholas Reay-Jones and Sanjay Dindyal and Tony Ng and Ashley Groves",

note = "Funding Information: This research/study/project was funded by and supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = dec,

doi = "10.1007/s00259-021-05318-y",

language = "English",

volume = "49",

pages = "371--384",

journal = "European Journal of Nuclear Medicine and Molecular Imaging",

issn = "1619-7070",

publisher = "SPRINGER",

number = "1",

}

Chen, SH, Miles, K, Taylor, SA, Ganeshan, B, Rodriquez, M, Fraioli, F, Wan, S, Afaq, A, Shortman, R, Walls, D, Hoy, L, Endozo, R, Bhargava, A, Hanson, M, Huang, J, Raouf, S, Francis, D, Siddiqi, S, Arulampalam, T, Sizer, B, Machesney, M, Reay-Jones, N, Dindyal, S, Ng, T & Groves, A 2021, 'FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis', European Journal of Nuclear Medicine and Molecular Imaging, vol. 49, no. 1, pp. 371-384. https://doi.org/10.1007/s00259-021-05318-y

TY - JOUR

T1 - FDG-PET/CT in colorectal cancer

T2 - potential for vascular-metabolic imaging to provide markers of prognosis

AU - Chen, Shih hsin

AU - Miles, Kenneth

AU - Taylor, Stuart A.

AU - Ganeshan, Balaji

AU - Rodriquez, Manuel

AU - Fraioli, Francesco

AU - Wan, Simon

AU - Afaq, Asim

AU - Shortman, Robert

AU - Walls, Darren

AU - Hoy, Luke

AU - Endozo, Raymond

AU - Bhargava, Aman

AU - Hanson, Matthew

AU - Huang, Joseph

AU - Raouf, Sherif

AU - Francis, Daren

AU - Siddiqi, Shahab

AU - Arulampalam, Tan

AU - Sizer, Bruce

AU - Machesney, Michael

AU - Reay-Jones, Nicholas

AU - Dindyal, Sanjay

AU - Ng, Tony

AU - Groves, Ashley

N1 - Funding Information: This research/study/project was funded by and supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Purpose: This study assesses the potential for vascular-metabolic imaging with FluoroDeoxyGlucose (FDG)–Positron Emission Tomography/Computed Tomography (PET/CT) perfusion to provide markers of prognosis specific to the site and stage of colorectal cancer. Methods: This prospective observational study comprised of participants with suspected colorectal cancer categorized as either (a) non-metastatic colon cancer (M0colon), (b) non-metastatic rectal cancer (M0rectum), or (c) metastatic colorectal cancer (M+). Combined FDG-PET/CT perfusion imaging was successfully performed in 286 participants (184 males, 102 females, age: 69.60 ± 10 years) deriving vascular and metabolic imaging parameters. Vascular and metabolic imaging parameters alone and in combination were investigated with respect to overall survival. Results: A vascular-metabolic signature that was significantly associated with poorer survival was identified for each patient group: M0colon – high Total Lesion Glycolysis (TLG) with increased Permeability Surface Area Product/Blood Flow (PS/BF), Hazard Ratio (HR) 3.472 (95% CI: 1.441–8.333), p = 0.006; M0rectum – high Metabolic Tumour Volume (MTV) with increased PS/BF, HR 4.567 (95% CI: 1.901–10.970), p = 0.001; M+ participants, high MTV with longer Time To Peak (TTP) enhancement, HR 2.421 (95% CI: 1.162–5.045), p = 0.018. In participants with stage 2 colon cancer as well as those with stage 3 rectal cancer, the vascular-metabolic signature could stratify the prognosis of these participants. Conclusion: Vascular and metabolic imaging using FDG-PET/CT can be used to synergise prognostic markers. The hazard ratios suggest that the technique may have clinical utility.

AB - Purpose: This study assesses the potential for vascular-metabolic imaging with FluoroDeoxyGlucose (FDG)–Positron Emission Tomography/Computed Tomography (PET/CT) perfusion to provide markers of prognosis specific to the site and stage of colorectal cancer. Methods: This prospective observational study comprised of participants with suspected colorectal cancer categorized as either (a) non-metastatic colon cancer (M0colon), (b) non-metastatic rectal cancer (M0rectum), or (c) metastatic colorectal cancer (M+). Combined FDG-PET/CT perfusion imaging was successfully performed in 286 participants (184 males, 102 females, age: 69.60 ± 10 years) deriving vascular and metabolic imaging parameters. Vascular and metabolic imaging parameters alone and in combination were investigated with respect to overall survival. Results: A vascular-metabolic signature that was significantly associated with poorer survival was identified for each patient group: M0colon – high Total Lesion Glycolysis (TLG) with increased Permeability Surface Area Product/Blood Flow (PS/BF), Hazard Ratio (HR) 3.472 (95% CI: 1.441–8.333), p = 0.006; M0rectum – high Metabolic Tumour Volume (MTV) with increased PS/BF, HR 4.567 (95% CI: 1.901–10.970), p = 0.001; M+ participants, high MTV with longer Time To Peak (TTP) enhancement, HR 2.421 (95% CI: 1.162–5.045), p = 0.018. In participants with stage 2 colon cancer as well as those with stage 3 rectal cancer, the vascular-metabolic signature could stratify the prognosis of these participants. Conclusion: Vascular and metabolic imaging using FDG-PET/CT can be used to synergise prognostic markers. The hazard ratios suggest that the technique may have clinical utility.

KW - Colorectal cancer

KW - CT perfusion

KW - FDG-PET

KW - Metabolism

KW - Survival

KW - Vascular

UR - http://www.scopus.com/inward/record.url?scp=85104267395&partnerID=8YFLogxK

U2 - 10.1007/s00259-021-05318-y

DO - 10.1007/s00259-021-05318-y

M3 - Article

C2 - 33837843

AN - SCOPUS:85104267395

SN - 1619-7070

VL - 49

SP - 371

EP - 384

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

IS - 1

ER -

FDG-PET/CT in colorectal cancer: potential for vascular-metabolic imaging to provide markers of prognosis

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Keywords

UN SDGs

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