[en] OBJECTIVE: Treating metastatic colorectal cancer with anti-EGFR monoclonal antibodies is recommended only for patients whose tumour does not harbour mutations of KRAS or NRAS. The aim of this study was to investigate the biology of rectal cancers and specifically to evaluate the relationship between fluorine-18 fludeoxyglucose (18F-FDG) positron emission tomography (PET) intensity and heterogeneity parameters and their mutational status. METHODS: 151 patients with newly diagnosed rectal cancer were included in this retrospective study. All patients underwent a baseline 18F-FDG PET/CT within a median time interval of 27 days of tumour tissue sampling, which was performed before any treatment. Standardized uptake values (SUVs), volume-based parameters and texture analysis were studied. We retrospectively performed KRAS genotyping on codons 12, 13, 61, 117 and 146, NRAS genotyping on codons 12, 13 and 61 and BRAF on codon 600. Associations between PET/CT parameters and the mutational status were assessed using univariate and multivariate analysis. RESULTS: 83 (55%) patients had an RAS mutation: 74 KRAS and 9 NRAS, while 68 patients had no mutation (wild-type tumours). No patient had BRAF mutation. First-order features based on intensity histogram analysis were significantly associated with RAS mutations: maximum SUV (SUVmax) (p-value = 0.002), mean SUV (p-value = 0.006), skewness (p-value = 0.049), SUV standard deviation (p-value = 0.001) and SUV coefficient of variation (SUVcov) (p-value = 0.001). Both SUVcov and SUVmax showed an area under the curve of 0.65 with sensitivity of 56% and 69%, respectively, and specificity of 64% and 52%, respectively. None of the volume-based (metabolic tumour volume and total lesion glycolysis), nor local or regional textural features were associated with the presence of RAS mutations. CONCLUSION: Although rectal cancers with KRAS or NRAS mutations display a significantly higher glucose metabolism than wild-type cancers, the accuracy of the currently proposed quantitative metrics extracted from 18F-FDG PET/CT is not sufficiently high for playing a meaningful clinical role. ADVANCES IN KNOWLEDGE: RAS-mutated rectal cancers have a significantly higher glucose metabolism. However, the accuracy of 18F-FDG PET/CT quantitative metrics is not as such as the technique could play a clinical role.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
LOVINFOSSE, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
KOOPMANSCH, Benjamin ; Centre Hospitalier Universitaire de Liège - CHU > Service de génétique
LAMBERT, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Service de génétique
JODOGNE, Sébastien ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale
KUSTERMANS, Gaëlle; Department of Pathology, Centre Hospitalier Universitaire de Liege, Li ` ege, Belgium ` 5
Hatt, Mathieu; LaTIM, INSERM UMR 1101, IBSAM, University of Brest, France
Visvikis, Dimitris; LaTIM, INSERM UMR 1101, IBSAM, University of Brest, France
SEIDEL, Laurence ; Centre Hospitalier Universitaire de Liège - CHU > Service des informations médico économiques (SIME)
POLUS, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive
Albert, Adelin ; Université de Liège > Département des sciences de la santé publique > Département des sciences de la santé publique
DELVENNE, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anatomie et cytologie pathologiques
HUSTINX, Roland ; Centre Hospitalier Universitaire de Liège - CHU > Service médical de médecine nucléaire et imagerie onco
Language :
English
Title :
18F-FDG PET/CT imaging in rectal cancer: relationship with the RAS mutational status.
Publication date :
2016
Journal title :
British Journal of Radiology
ISSN :
0007-1285
eISSN :
1748-880X
Publisher :
British Institute of Radiology, London, United Kingdom
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