Department of Nuclear Medicine, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
Abdom Radiol (NY). 2022 Apr;47(4):1255-1264. doi: 10.1007/s00261-022-03432-5. Epub 2022 Feb 9.
The study aimed to evaluate the relationship between intra-tumor metabolic heterogeneity parameters of F-FDG and KRAS mutation status in colorectal cancer (CRC) patients and which threshold heterogeneity parameters could better reflect the heterogeneity characteristics of colorectal cancer.
Medical data of 101 CRC patients who underwent F-FDG PET/CT and KRAS mutation analysis were selected. On PET scans, F-FDG traditional indices maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity parameters coefficient of variation with a threshold of 2.5 (CV), CV, heterogeneity index-1 (HI-1), and HI-2 of the primary lesions were obtained. We inferred correlations between these F-FDG parameters and KRAS mutation status.
41 patients (40.6%) had KRAS gene mutation. Assessment of FDG parameters showed that SUVmax (19.00 vs. 13.16, p < 0.001), MTV (11.64 vs. 8.83, p = 0.001), and TLG (102.85 vs. 69.76, p < 0.001), CV (0.55 vs. 0.46, p = 0.006), and HI-2 (14.03 vs. 7.59, p < 0.001) of KRAS mutation were higher compared to wild-type (WT) KRAS. CV (0.22 vs. 0.24, p = 0.001) was lower in the KRAS mutation group, while HI-1 had no significant difference between the two groups. Multivariate analysis showed that MTV (OR = 4.97, 1.04-23.83, p = 0.045) was the only significant predictor in KRAS mutation, using a cut-off of 7.62 (AUC = 0.695), and MTV showed a sensitivity of 90.2% and specificity of 45.0%. However, the PET parameters were not independent predictors in KRAS mutation.
KRAS gene mutant CRC patients had more F-FDG uptake (SUVmax, MTV, TLG) and heterogeneity (CV, HI-2) than WT KRAS. MTV was the only independent predictor of KRAS gene mutation in colorectal cancer patients.
本研究旨在评估结直肠癌（CRC）患者肿瘤内代谢异质性参数与 KRAS 突变状态之间的关系，以及哪种异质性参数能更好地反映结直肠癌的异质性特征。
选取 101 例接受 F-FDG PET/CT 和 KRAS 突变分析的 CRC 患者的医学数据。在 PET 扫描中，获得原发肿瘤的 F-FDG 传统指标最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）以及异质性参数阈值为 2.5 的变异系数（CV）、CV、异质性指数-1（HI-1）和 HI-2。我们推断这些 F-FDG 参数与 KRAS 突变状态之间的相关性。
41 例（40.6%）患者存在 KRAS 基因突变。评估 FDG 参数显示，SUVmax（19.00 比 13.16，p<0.001）、MTV（11.64 比 8.83，p=0.001）和 TLG（102.85 比 69.76，p<0.001）、CV（0.55 比 0.46，p=0.006）和 HI-2（14.03 比 7.59，p<0.001）在 KRAS 突变组中更高，而 CV（0.22 比 0.24，p=0.001）在 KRAS 突变组中更低，而 HI-1 在两组之间无显著差异。多变量分析显示，MTV（OR=4.97，1.04-23.83，p=0.045）是 KRAS 突变的唯一显著预测因子，截断值为 7.62（AUC=0.695），MTV 的敏感性为 90.2%，特异性为 45.0%。然而，PET 参数不是 KRAS 突变的独立预测因子。
KRAS 基因突变型 CRC 患者的 F-FDG 摄取（SUVmax、MTV、TLG）和异质性（CV、HI-2）均高于 WT KRAS。MTV 是结直肠癌患者 KRAS 基因突变的唯一独立预测因子。
