Abstract
BackgroundA combination of positron emission tomography and computed tomography (PET/CT) is an important modality for the diagnosis of carcinoma. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported as metabolic parameters in PET/CT since the late 1990s, and they are expected to be useful in diagnosing diverse cancers and as prognostic biomarkers. We evaluated the potential of these parameters in the prognosis of colorectal cancer (CRC) by comparing them with conventional parameters, including the maximum standardized uptake value (SUVmax). We enrolled 84 patients who underwent surgery for CRC without distal metastasis between April 2015 and April 2019. SUVmax, MTV, and TLG were measured by 18F-fluorodeoxyglucose (FDG)-PET/CT. To find an optimal threshold value related to prognosis, the volume of interest in the primary carcinoma was measured at fixed relative and absolute thresholds based on SUVmax (30%, 40%, and 50%; 2.5, 3.0, and 3.5, respectively), tumor-to-liver standardized uptake ratios, TLR (1.0, 1.5, and 2.0), and SUV normalized to lean body mass, SUL (2.0, 2.5, and 3.0). After classifying the patients into two groups according to pathological N stage, the optimal threshold values of all metabolic parameters were compared between groups using a non-parametric comparison test.ResultThe most suitable thresholds for MTV were a SUVmax of 3.5 and a TLR 2.0. TLG with a SUVmax value of 40% showed the most significant difference. The MTV standard uptake ratio of 2.0 was significantly associated with pathological N stage.ConclusionOur results suggest that an MTV TLR 2.0 on PET/CT reflects pathological N stage in local patients with CRC.
Highlights
A combination of positron emission tomography and computed tomography (PET/CT) is an important modality for the diagnosis of carcinoma
Our results suggest that an Metabolic tumor volume (MTV) Tumor-to-liver ratio (TLR) 2.0 on Positron emission tomography (PET)/CT reflects pathological N stage in local patients with colorectal cancer (CRC)
To validate the hypothesis that MTV and total lesion glycolysis (TLG) are better biomarkers than existing parameters for predicting recurrence of CRC, we investigated the optimal threshold value of these parameters among the various thresholds reported in the literature to be useful in prognosis, as well as their association with CRC prognosis, after curative resection without preoperative adjuvant therapy
Summary
A combination of positron emission tomography and computed tomography (PET/CT) is an important modality for the diagnosis of carcinoma. Kido et al EJNMMI Res (2021) 11:87 the maximal value in a voxel of a tumor as imaged with 18F-FDG PET, the SUVmax is a semiquantitative metabolic parameter that is often used to evaluate the prognosis of patients with CRC [2]. It does not adequately indicate the extent of glucose metabolism in volume-based glucose metabolic analysis. As the backgrounds of patients in these T- and N-stage groups were unknown, it cannot be concluded whether MTV and TLG were truly associated with these stages
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