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Statistical Modeling of Relations Between PET/CT Parameters and CEA in Recurrent and Metastatic Colorectal Cancer
Renata Milardovic1, Lejla Dzananovic2, Semir Beslija3
1Clinic of Nuclear Medicine and Endocrinology, Clinical Center of Sarajevo University, Sarajevo, Bosnia and Herzegovina.
This study found that Tumor-to-Liver-Glycolysis (TLG) measured by 18F-FDG PET/CT has prognostic value in recurrent and metastatic colorectal cancer (CRC). Further research is needed to confirm these findings in larger patient groups.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiology
Background:
- Colorectal cancer (CRC) exhibits diverse clinical, pathological, and molecular features influencing its behavior, treatment response, and prognosis.
- Accurate assessment of recurrent and metastatic CRC is crucial for effective patient management and treatment planning.
Purpose of the Study:
- To evaluate the correlation between metabolic parameters from 18F-FDG PET/CT (SUVmax, MTV, TLG) and Carcinoembryonic Antigen (CEA) in recurrent and metastatic CRC.
- To assess the prognostic value of these metabolic parameters in predicting outcomes for patients with recurrent and metastatic CRC.
Main Methods:
- A descriptive study involving 100 patients with previously treated CRC and suspected recurrence or metastasis underwent 18F-FDG PET/CT.
- Metabolic parameters (SUVmax, MTV, TLG) were calculated for hypermetabolic lesions. CEA levels were measured, and correlation and survival analyses (18-month progression-free survival) were performed.
- Diagnostic performance of 18F-FDG PET/CT and CEA was evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Main Results:
- 18F-FDG PET/CT demonstrated high sensitivity (95%) and NPV (95%) for detecting recurrent/metastatic CRC, while CEA showed high specificity (96%) and PPV (91%).
- Significant positive correlation was found between CEA and Tumor-to-Liver-Glycolysis (TLG) (r=0.67).
- Survival analysis indicated that only TLG (HR=0.45, p=0.028) had a significant prognostic role in CRC, unlike SUVmax and MTV.
Conclusions:
- Metabolic parameters derived from 18F-FDG PET/CT, particularly TLG, show potential prognostic value in recurrent and metastatic colorectal cancer.
- While 18F-FDG PET/CT is effective for detection, TLG may offer additional prognostic information.
- Further multicentric prospective studies are necessary to validate the prognostic role of these metabolic parameters in CRC.
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