title: Genetic Alterations in Colorectal Cancer Have Different Patterns on 18F-FDG PET/CT.
abstract: OBJECTIVE
  The aim of this study was to understand the association between various genetic mutation and (18)F-FDG PET-related parameters in patients with colorectal cancer (CRC).
  
  
  METHODS
  One hundred three CRC patients who had undergone preoperative PET/CTs were included in this study. Several PET/CT-related parameters, including SUV(max), and various thresholds of metabolic tumor volume, total lesion glycolysis, and PET/CT-based tumor width (TW) were measured. Using high-resolution melting methods for genetic mutation analysis, tumor- and PET/CT-related parameters were correlated with various genetic alterations including TP53, KRAS, APC, BRAF, and PIK3CA. Mann-Whitney U test and logistic regression analysis were carried out for this analysis.
  
  
  RESULTS
  Genetic alterations in TP53, KRAS, and APC were found in 41 (40%), 34 (33%), and 27 (26%) of tumors, respectively. PIK3CA and BRAF were exhibited by 5 and 4 of the patients with CRC. TP53 mutants exhibited higher SUV(max). The odds ratio was 1.28 (P = 0.04; 95% confidence interval, 1.01-1.61). Tumors with a mutated KRAS had an increased accumulation of FDG using a 40% threshold level for maximal uptake of TW (TW(40%)), whereas the odds ratio was 1.15 (P = 0.001; 95% confidence interval, 1.06-1.24). The accuracy of SUV(max) greater than 10 in predicting TP53 mutation was 60%, whereas that for TW(40%) for KRAS was 61%.
  
  
  CONCLUSIONS
  Increased SUV(max) and TW(40%) were associated in CRC tumors with TP53 and KRAS mutations, respectively. Further studies are required because of the low predictive accuracy.
authors.affiliation: From the *Department of Radiation Oncology, China Medical University Hospital; †College of Medicine, China Medical University, Taichung; ‡College of Medicine, Taipei Medical University, Taipei; §Graduate Institute of Clinical Medical Sciences, China Medical University; ║Department of Laboratory Medicine, China Medical University Hospital; ¶Department of Nursing, Hungkuang University; **Epigenome Research Center and ††Department of Nuclear Medicine and PET Center, China Medical University Hospital; and ‡‡Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shang-Wen
authors.initials: SW
authors.lastname: Chen
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Cheng-Man
authors.initials: CM
authors.lastname: Ho
authors.forename: Ya-Sian
authors.initials: YS
authors.lastname: Chang
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Yang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
authors.forename: Jan-Gowth
authors.initials: JG
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009154:Mutation; D049268:Positron-Emission Tomography; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000235:genetics; D018631:ras Proteins / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D019275:Radiopharmaceuticals; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D019788:Fluorodeoxyglucose F18; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins