Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer

Linda Heijmen, Edwin E.G.W. ter Voert, Wim J.G. Oyen, Cornelis J.A. Punt, Dick Johan van Spronsen, Arend Heerschap, Lioe-Fee de Geus-Oei, Anneke W.M. van Laarhoven

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Abstract

Aim Aim of this study was to investigate the potential of 18F-FDG PET, diffusion weighted imaging (DWI) and susceptibility-weighted (T2*) MRI to predict response to systemic treatment in patients with colorectal liver metastases. The predictive values of pretreatment measurements and of early changes one week after start of therapy, were evaluated. Methods Imaging was performed prior to and one week after start of first line chemotherapy in 39 patients with colorectal liver metastases. 18F-FDG PET scans were performed on a PET/CT scanner and DWI and T2* were performed on a 1.5T MR scanner. The maximum standardized uptake values (SUV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) and T2* value were assessed in the same lesions. Up to 5 liver metastases per patient were analyzed. Outcome measures were progression free survival (PFS), overall survival (OS) and size response. Results Pretreatment, high SUVmax, high TLG, low ADC and high T2* were associated with a shorter OS. Low pretreatment ADC value was associated with shorter PFS. After 1 week a significant drop in SUVmax and rise in ADC were observed. The drop in SUV was correlated with the rise in ADC (r=-0.58, p=0.002). Neither change in ADC nor in SUV was predictive of PFS or OS. T2* did not significantly change after start of treatment. Conclusion Pretreatment SUVmax, TLG, ADC, and T2* values in colorectal liver metastases are predictive of patient outcome. Despite sensitivity of DWI and 18F-FDG PET for early treatment effects, change in these parameters was not predictive of long term outcome
Original languageEnglish
Article numbere0120823
JournalPLoS ONE
Volume10
Issue number4
DOIs
Publication statusPublished - 1 Apr 2015

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colorectal neoplasms
diffusivity
Colorectal Neoplasms
image analysis
Imaging techniques
lesions (animal)
metastasis
glycolysis
Liver
liver
Fluorodeoxyglucose F18
Glycolysis
scanners
uptake mechanisms
Neoplasm Metastasis
Disease-Free Survival
Therapeutics
pretreatment
positron-emission tomography
Survival

Keywords

  • METIS-310193
  • IR-95455

Cite this

Heijmen, L., ter Voert, E. E. G. W., Oyen, W. J. G., Punt, C. J. A., van Spronsen, D. J., Heerschap, A., ... van Laarhoven, A. W. M. (2015). Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer. PLoS ONE, 10(4), [e0120823]. https://doi.org/10.1371/journal.pone.0120823
Heijmen, Linda ; ter Voert, Edwin E.G.W. ; Oyen, Wim J.G. ; Punt, Cornelis J.A. ; van Spronsen, Dick Johan ; Heerschap, Arend ; de Geus-Oei, Lioe-Fee ; van Laarhoven, Anneke W.M. / Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer. In: PLoS ONE. 2015 ; Vol. 10, No. 4.
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title = "Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer",
abstract = "Aim Aim of this study was to investigate the potential of 18F-FDG PET, diffusion weighted imaging (DWI) and susceptibility-weighted (T2*) MRI to predict response to systemic treatment in patients with colorectal liver metastases. The predictive values of pretreatment measurements and of early changes one week after start of therapy, were evaluated. Methods Imaging was performed prior to and one week after start of first line chemotherapy in 39 patients with colorectal liver metastases. 18F-FDG PET scans were performed on a PET/CT scanner and DWI and T2* were performed on a 1.5T MR scanner. The maximum standardized uptake values (SUV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) and T2* value were assessed in the same lesions. Up to 5 liver metastases per patient were analyzed. Outcome measures were progression free survival (PFS), overall survival (OS) and size response. Results Pretreatment, high SUVmax, high TLG, low ADC and high T2* were associated with a shorter OS. Low pretreatment ADC value was associated with shorter PFS. After 1 week a significant drop in SUVmax and rise in ADC were observed. The drop in SUV was correlated with the rise in ADC (r=-0.58, p=0.002). Neither change in ADC nor in SUV was predictive of PFS or OS. T2* did not significantly change after start of treatment. Conclusion Pretreatment SUVmax, TLG, ADC, and T2* values in colorectal liver metastases are predictive of patient outcome. Despite sensitivity of DWI and 18F-FDG PET for early treatment effects, change in these parameters was not predictive of long term outcome",
keywords = "METIS-310193, IR-95455",
author = "Linda Heijmen and {ter Voert}, {Edwin E.G.W.} and Oyen, {Wim J.G.} and Punt, {Cornelis J.A.} and {van Spronsen}, {Dick Johan} and Arend Heerschap and {de Geus-Oei}, Lioe-Fee and {van Laarhoven}, {Anneke W.M.}",
year = "2015",
month = "4",
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doi = "10.1371/journal.pone.0120823",
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Heijmen, L, ter Voert, EEGW, Oyen, WJG, Punt, CJA, van Spronsen, DJ, Heerschap, A, de Geus-Oei, L-F & van Laarhoven, AWM 2015, 'Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer', PLoS ONE, vol. 10, no. 4, e0120823. https://doi.org/10.1371/journal.pone.0120823

Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer. / Heijmen, Linda; ter Voert, Edwin E.G.W.; Oyen, Wim J.G.; Punt, Cornelis J.A.; van Spronsen, Dick Johan; Heerschap, Arend; de Geus-Oei, Lioe-Fee; van Laarhoven, Anneke W.M.

In: PLoS ONE, Vol. 10, No. 4, e0120823, 01.04.2015.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer

AU - Heijmen, Linda

AU - ter Voert, Edwin E.G.W.

AU - Oyen, Wim J.G.

AU - Punt, Cornelis J.A.

AU - van Spronsen, Dick Johan

AU - Heerschap, Arend

AU - de Geus-Oei, Lioe-Fee

AU - van Laarhoven, Anneke W.M.

PY - 2015/4/1

Y1 - 2015/4/1

N2 - Aim Aim of this study was to investigate the potential of 18F-FDG PET, diffusion weighted imaging (DWI) and susceptibility-weighted (T2*) MRI to predict response to systemic treatment in patients with colorectal liver metastases. The predictive values of pretreatment measurements and of early changes one week after start of therapy, were evaluated. Methods Imaging was performed prior to and one week after start of first line chemotherapy in 39 patients with colorectal liver metastases. 18F-FDG PET scans were performed on a PET/CT scanner and DWI and T2* were performed on a 1.5T MR scanner. The maximum standardized uptake values (SUV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) and T2* value were assessed in the same lesions. Up to 5 liver metastases per patient were analyzed. Outcome measures were progression free survival (PFS), overall survival (OS) and size response. Results Pretreatment, high SUVmax, high TLG, low ADC and high T2* were associated with a shorter OS. Low pretreatment ADC value was associated with shorter PFS. After 1 week a significant drop in SUVmax and rise in ADC were observed. The drop in SUV was correlated with the rise in ADC (r=-0.58, p=0.002). Neither change in ADC nor in SUV was predictive of PFS or OS. T2* did not significantly change after start of treatment. Conclusion Pretreatment SUVmax, TLG, ADC, and T2* values in colorectal liver metastases are predictive of patient outcome. Despite sensitivity of DWI and 18F-FDG PET for early treatment effects, change in these parameters was not predictive of long term outcome

AB - Aim Aim of this study was to investigate the potential of 18F-FDG PET, diffusion weighted imaging (DWI) and susceptibility-weighted (T2*) MRI to predict response to systemic treatment in patients with colorectal liver metastases. The predictive values of pretreatment measurements and of early changes one week after start of therapy, were evaluated. Methods Imaging was performed prior to and one week after start of first line chemotherapy in 39 patients with colorectal liver metastases. 18F-FDG PET scans were performed on a PET/CT scanner and DWI and T2* were performed on a 1.5T MR scanner. The maximum standardized uptake values (SUV), total lesion glycolysis (TLG), apparent diffusion coefficient (ADC) and T2* value were assessed in the same lesions. Up to 5 liver metastases per patient were analyzed. Outcome measures were progression free survival (PFS), overall survival (OS) and size response. Results Pretreatment, high SUVmax, high TLG, low ADC and high T2* were associated with a shorter OS. Low pretreatment ADC value was associated with shorter PFS. After 1 week a significant drop in SUVmax and rise in ADC were observed. The drop in SUV was correlated with the rise in ADC (r=-0.58, p=0.002). Neither change in ADC nor in SUV was predictive of PFS or OS. T2* did not significantly change after start of treatment. Conclusion Pretreatment SUVmax, TLG, ADC, and T2* values in colorectal liver metastases are predictive of patient outcome. Despite sensitivity of DWI and 18F-FDG PET for early treatment effects, change in these parameters was not predictive of long term outcome

KW - METIS-310193

KW - IR-95455

U2 - 10.1371/journal.pone.0120823

DO - 10.1371/journal.pone.0120823

M3 - Article

VL - 10

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

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Heijmen L, ter Voert EEGW, Oyen WJG, Punt CJA, van Spronsen DJ, Heerschap A et al. Multimodality Imaging to Predict Response to Systemic Treatment in Patients with Advanced Colorectal Cancer. PLoS ONE. 2015 Apr 1;10(4). e0120823. https://doi.org/10.1371/journal.pone.0120823