PET-CT as a predictor of outcome in resectable colorectal liver metastases.
BACKGROUND
PET-computed tomography (PET-CT) is a useful staging imaging modality in colorectal liver metastases (CRLM). This study aimed to determine whether PET-CT parameters, standardized uptake value (SUV) and reconstructed tumour volume (RTV), are predictors of prognosis and survival.


METHODS
A study of all resectable CRLM patients in the regional HPB unit from 2007-2009 was performed. Preoperative PET-CT scans were retrospectively reviewed; SUV, diameter and RTV for each lesion was recorded. Correlation analysis was performed with other pathological and biochemical parameters, by Pearson's correlation analysis. Survival analysis was performed using Cox regression hazard model. A P value of less than 0.05 was considered statistically significant.


RESULTS
A total of 79 patients were included. SUV moderately correlated with tumour diameter, both PET-CT (r=0.4927; P<0.0001) and histology (r=0.4513; P=0.0003); RTV (r=0.4489; P<0.001), preoperative carcinoembryonic antigen (CEA) (r=0.4977; P=0.0001), and postoperative CEA (r=0.3727; P=0.004). Multivariate analysis found that an independent predictor of SUVmax was preoperative CEA (P=0.03). RTV strongly correlated with preoperative CEA (r=0.9389; P<0.0001). SUV and RTV had a negative effect on survival.


CONCLUSIONS
PET-CT, in the setting of CRLM, may have a prognostic role in assessing survival. Although no definite conclusions can be drawn regarding the prognostic role of SUV and RTV, it acts to reinforce the need for further prospective studies to validate these findings.
aDepartment of HPB Surgery, Mater Hospital bDepartment of Nuclear Medicine, Belfast City Hospital, Belfast Health and Social Care Trust cSchool of Medicine, Dentistry and Biomedical Sciences, Centre of Public Health dCCRCB, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
Claire
C
Jones
Stephen A
SA
Badger
Mike
M
Stevenson
Tom
T
Diamond
Lloyd D
LD
McKie
Mark A
MA
Taylor
Richard H
RH
Wilson
Tom B
TB
Lynch
D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
D002272:Carcinoembryonic Antigen