AUTHOR=Liu Xin , Zhang Yi-Fan , Shi Qin , Yang Yi , Yao Ben-Hu , Wang Shi-Cun , Geng Guang-Yong 

TITLE=Prediction value of 18F-FDG PET/CT intratumor metabolic heterogeneity parameters for recurrence after radical surgery of stage II/III colorectal cancer

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.945939

DOI=10.3389/fonc.2022.945939

ISSN=2234-943X

ABSTRACT=<sec><title>Purpose</title><p>We explored the predictive effect of intratumor metabolic heterogeneity indices extracted from <sup>18</sup>F-FDG PET/CT on recurrence in stage II/III colorectal cancer after radical surgery.</p></sec><sec><title>Methods</title><p>A total of 140 stage II/III colorectal cancer patients who received preoperative <sup>18</sup>F-FDG PET/CT and radical resection were enrolled. <sup>18</sup>F-FDG traditional parameters including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) under different thresholds; heterogeneity indices including the coefficient of variation with SUV 2.5 as a threshold (CV2.5), CV40%, heterogeneity index-1 (HI-1) calculated by the fixed-threshold method, and HI-2 calculated by the percentage threshold method; and clinicopathological information were collected. We concluded that relationships exist between these data and patients’ disease-free survival (DFS).</p></sec><sec><title>Results</title><p>Regional lymph node status (<italic>P</italic> &lt; 0.001), nerve invasion (<italic>P</italic> = 0.036), tumor thrombus (<italic>P</italic> = 0.005), and HI-1 (<italic>P</italic> = 0.010) exhibited significant differences between the relapse and non-relapse groups, while SUVmax, MTV2.5, MTV40%, TLG2.5, TLG40%, CV2.5, CV40%, HI-2, and other clinicopathological factors had no differences between the relapse and non-relapse groups. Multivariate analysis demonstrated that HI-1 (HR = 1.02, 1.00–1.04, <italic>P</italic> = 0.038), regional lymph node metastasis (HR = 2.95, 1.37–6.38, <italic>P</italic> = 0.006), and tumor thrombus status (HR = 2.37, 1.13–4.99, <italic>P</italic> = 0.022) were independent factors significantly related to DFS.</p></sec><sec><title>Conclusion</title><p>HI-1, tumor thrombus status, and regional lymph node status could predict the recurrence of stage II/III colorectal cancer after radical resection and had an advantage over other <sup>18</sup>F-FDG PET/CT conventional parameters and heterogeneity indices.</p></sec>