Annals of Oncology Advance Access originally published online on October 24, 2007
Annals of Oncology 2008 19(2):348-352; doi:10.1093/annonc/mdm470
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gastrointestinal tumors |
Chemotherapy response evaluation with FDG–PET in patients with colorectal cancer
1 Department of Nuclear Medicine
2 Department of Medical Oncology
3 Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
* Correspondence to: Dr L. F. de Geus-Oei, Department of Nuclear Medicine (internal postal code 444), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31-24-3614048; Fax: +31-24-3618942; E-mail: l.degeus-oei{at}nucmed.umcn.nl
Background: The aim of this prospective study was to evaluate the value of F-18-fluorodeoxyglucose–positron emission tomography (FDG–PET) for early assessment of chemotherapy response in patients with advanced colorectal cancer.
Methods: Dynamic FDG–PET was carried out before and at 2 (n = 50) and 6 months (n = 19) after the start of treatment. Quantitative Patlak analysis [metabolic rate of glucose (MRGlu)] and a simplified method to measure glucose metabolism [standardized uptake value (SUV)] were evaluated. The predictive value of changes in glucose metabolism was assessed with Cox proportional regression analysis. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan–Meier estimates.
Results: There was an increase in the rates of death (P = 0.049 for 
MRGlu PET1–2; P = 0.017 for SUV PET1–2; P = 0.032 for MRGlu PET1–3; P = 0.048 for SUV PET1–3) and progression (P = 0.026 for MRGlu PET1–2; P = 0.035 for SUV PET1–2; P = 0.041 for MRGlu PET1–3; P = 0.081 for SUV PET1–3) associated with worse response as assessed by PET on Cox proportional regression analysis. The OS and PFS analysis showed a significant predictive value at broad ranges of MRGlu and SUV cut-off levels.
Conclusion: The degree of chemotherapy-induced changes in tumor glucose metabolism is highly predictive for patient outcome. The use of FDG–PET for therapy monitoring seems clinically feasible since simplified methods (SUV) are sufficiently reliable.
Key words: chemotherapy response monitoring, colorectal cancer, F-18-fluorodeoxyglucose–positron emission tomography (FDG–PET), Patlak analysis (MRGlu), standardized uptake value (SUV)
Received for publication June 8, 2007. Revision received August 21, 2007. Accepted for publication September 4, 2007.
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