title: Metabolic Tumor Volume and Total Lesion Glycolysis in PET/CT Correlate With the Pathological Findings of Colorectal Cancer and Allow Its Accurate Staging.
abstract: BACKGROUND
  PET/CT plays an important role in cancer diagnosis. Recently, novel metabolic parameters in PET/CT such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported to be diagnostic and prognostic biomarkers of various cancers. We evaluated the diagnostic value of these metabolic parameters in colorectal cancer (CRC).
  
  
  METHODS
  The study included 138 patients who underwent surgical resection of CRCs between August 2012 and March 2014. The MTVs and TLGs of tumors were measured using various SUV thresholds. The diagnostic abilities of the metabolic parameters were analyzed using ROC curves and classification and regression trees.
  
  
  RESULTS
  The AUCs of the MTVs and TLGs for predicting T stage (0.881-0.892) were significantly higher than the AUC of the SUVmax (0.824). In the M stage, the AUCs of MTVs and TLGs (0.688-0.723) were significantly higher than that of the SUVmax (0.606). Recursive partitioning applying classification and regression trees demonstrated that the optimal cutoff values of the most important variables for discriminating T, N, and M stages are MTV2.5 = 9.35 and 63.33 mL, TLG50% = 328.1, and TLG50% = 94.81, respectively.
  
  
  CONCLUSIONS
  Metabolic tumor volumes and TLGs in PET/CT are reliable diagnostic biomarkers. Using these parameters, more accurate preoperative diagnoses for CRC can be made.
authors.affiliation: From the Departments of *Surgery, and †Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Koji
authors.initials: K
authors.lastname: Okabayashi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Tsuruta
authors.forename: Kohei
authors.initials: K
authors.lastname: Shigeta
authors.forename: Koji
authors.initials: K
authors.lastname: Murakami
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006019:Glycolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D019788:Fluorodeoxyglucose F18