结直肠癌肝转移中 KRAS 突变与双时相 F-FDG PET/CT 成像的关系。

Relationship between KRAS mutations and dual time point F-FDG PET/CT imaging in colorectal liver metastases.

机构信息

Shanghai Institute of Medical Imaging, Shanghai, 200032, China.

Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.

出版信息

Abdom Radiol (NY). 2019 Jun;44(6):2059-2066. doi: 10.1007/s00261-018-1740-8.

DOI:10.1007/s00261-018-1740-8

PMID:30143816

Abstract

PURPOSE

To investigate the association between metabolic parameters of dual time point F-FDG PET/CT imaging and Kirsten rat sarcoma (KRAS) mutation status in colorectal liver metastases (CRLM).

METHODS

Forty-nine colorectal cancer patients with 87 liver metastatic lesions were included in this retrospective study. KRAS gene mutation tests were also performed for all the patients. The maximum standardized uptake value (SUV) was measured for each hepatic metastatic lesion on both early and delayed scans, and the change of SUV (ΔSUV) and retention index (RI) were calculated. Uni-variate and multi-variate analyses were employed to determine the relationship between any PET/CT parameters and KRAS mutation status.

RESULTS

Thirty-seven (42.5%) liver metastatic lesions harboring KRAS mutations were identified. The SUV of CRLM with KRAS mutation both on early and delayed scans was significantly higher than those with wild-type KRAS (10.7 ± 6.0 vs. 7.8 ± 3.3, P = 0.002; 15.5 ± 10.1 vs. 10.0 ± 4.2, P < 0.001, respectively). Compared with wild-type KRAS CRLM, ΔSUV and RI (%) of CRLM with KRAS mutation were also significantly higher than those with wild-type KRAS (4.8 ± 4.7 vs. 2.2 ± 2.0, P < 0.001; 45.3 ± 28.2 vs. 29.6 ± 24.7, P = 0.003, respectively). Multi-variate analyses showed that the SUV on both early and delayed scans, ΔSUV, and RI (%) were the 4 independent factors to predict CRLM patients harboring KRAS mutations.

CONCLUSION

The SUV on both early and delayed scans, ΔSUV, and RI (%) may be the 4 independent factors to predict CRLM patients harboring KRAS mutations.

摘要

目的

研究双时相 F-FDG PET/CT 代谢参数与结直肠癌肝转移（CRLM）中 KRAS 突变状态的相关性。

方法

本回顾性研究纳入了 49 例结直肠癌伴 87 个肝转移病灶的患者。对所有患者均进行 KRAS 基因突变检测。对每个肝转移病灶的早期和延迟扫描分别测量最大标准化摄取值（SUV），并计算 SUV 的变化（ΔSUV）和滞留指数（RI）。采用单变量和多变量分析确定任何 PET/CT 参数与 KRAS 突变状态之间的关系。

结果

共发现 37 个（42.5%）肝转移病灶存在 KRAS 突变。KRAS 突变的 CRLM 在早期和延迟扫描时的 SUV 均显著高于 KRAS 野生型（10.7±6.0 比 7.8±3.3，P=0.002；15.5±10.1 比 10.0±4.2，P<0.001）。与 KRAS 野生型 CRLM 相比，KRAS 突变的 CRLM 的 ΔSUV 和 RI（%）也显著高于 KRAS 野生型（4.8±4.7 比 2.2±2.0，P<0.001；45.3±28.2 比 29.6±24.7，P=0.003）。多变量分析显示，早期和延迟扫描时的 SUV、ΔSUV 和 RI（%）是预测 CRLM 患者 KRAS 突变的 4 个独立因素。