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Clinical Nuclear Medicine:
doi: 10.1097/RLU.0000000000000481
Original Articles

Correlation Between PET/CT Parameters and KRAS Expression in Colorectal Cancer

Chen, Shang-Wen MD*†‡; Chiang, Hua-Che MD§; Chen, William Tzu-Liang MD†§; Hsieh, Te-Chun MD∥¶; Yen, Kuo-Yang MD∥¶; Chiang, Shu-Fen MD**; Kao, Chia-Hung MD†∥

Supplemental Author Material
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Abstract

Purpose

The objective of this study was to correlate the association between mutated KRAS and wild-type colorectal cancer (CRC) by using various 18F-FDG PET–related parameters.

Methods

One hundred twenty-one CRC patients who had undergone preoperative PET/CT were included in this study. Several PET/CT-related parameters, including SUVmax and various thresholds of metabolic tumor volume, total lesion glycolysis, and PET/CT-based tumor width, were measured. Tumor- and PET/CT-related parameters were correlated with genomic expression between KRAS mutant and wild-type groups, using a Mann-Whitney U test and logistic regression analysis.

Results

Colorectal cancer tumors with a mutated KRAS exhibited higher SUVmax and an increased accumulation of FDG among several threshold methods. Multivariate analysis showed that SUVmax and using a 40% threshold level for maximal uptake of TW (TW40%) were the 2 predictors of KRAS mutations. The odds ratio was 1.23 for SUVmax (P = 0.02; 95% confidence interval, 1.01–1.52) and 1.15 for TW40% (P = 0.02; 95% confidence interval, 1.02–1.30). The accuracy of SUVmax for predicting mutated KRAS was higher in patients with colon or sigmoid colon cancers, whereas it was TW40% in those with rectal cancers.

Conclusions

SUVmax and TW40% were associated in CRC with KRAS mutations. PET/CT parameters can supplement genomic analysis to determine KRAS expression in CRC.

Copyright © 2014 by Lippincott Williams & Wilkins

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