Yong-Il Kim1, Hyo Sang Lee2, Joon Young Choi3. 1. From the Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul. 2. Department of Nuclear Medicine, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung. 3. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
PURPOSE: Colorectal liver metastasis (CRLM) remains a clinical challenge due to the lack of reliable prognostic parameters. We performed a systematic review and meta-analysis of the prognostic value of pretreatment 18F-FDG PET/CT volumetric parameters for hepatic metastatic lesions (HMLs) in patients with CRLM. METHODS: A systematic search was performed using the following combination of keywords: CRLM, FDG, PET, and prognosis. The inclusion criteria were studies using 18F-FDG PET/CT as an imaging tool before treatment, including volumetric parameters (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) for HMLs, and reported survival data. Event-free survival and overall survival were considered as survival markers. The effect on survival was determined by the effect size of the hazard ratio (HR) with 95% confidence interval (CI). RESULTS: Our systematic search identified 668 records, and a total of 10 studies comprising 494 patients were included. The pooled HRs of the prognostic value of the MTV and TLG for event-free survival were 1.55 (95% CI, 1.21-1.99; P = 0.0006) and 1.64 (95% CI, 1.23-2.19; P = 0.0009) with significance, respectively. The pooled HRs of the prognostic value of the MTV and TLG for overall survival were 1.72 (95% CI, 1.32-2.23; P < 0.0001) and 2.09 (95% CI, 1.48-2.96; P < 0.0001) with significance, respectively. CONCLUSIONS: Higher MTV and TLG for HMLs before treatment were identified as worse prognostic parameters in patients with CRLM. The MTV and TLG of 18F-FDG PET/CT could be used as predictors of prognosis.
PURPOSE:Colorectal liver metastasis (CRLM) remains a clinical challenge due to the lack of reliable prognostic parameters. We performed a systematic review and meta-analysis of the prognostic value of pretreatment 18F-FDG PET/CT volumetric parameters for hepatic metastatic lesions (HMLs) in patients with CRLM. METHODS: A systematic search was performed using the following combination of keywords: CRLM, FDG, PET, and prognosis. The inclusion criteria were studies using 18F-FDG PET/CT as an imaging tool before treatment, including volumetric parameters (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) for HMLs, and reported survival data. Event-free survival and overall survival were considered as survival markers. The effect on survival was determined by the effect size of the hazard ratio (HR) with 95% confidence interval (CI). RESULTS: Our systematic search identified 668 records, and a total of 10 studies comprising 494 patients were included. The pooled HRs of the prognostic value of the MTV and TLG for event-free survival were 1.55 (95% CI, 1.21-1.99; P = 0.0006) and 1.64 (95% CI, 1.23-2.19; P = 0.0009) with significance, respectively. The pooled HRs of the prognostic value of the MTV and TLG for overall survival were 1.72 (95% CI, 1.32-2.23; P < 0.0001) and 2.09 (95% CI, 1.48-2.96; P < 0.0001) with significance, respectively. CONCLUSIONS: Higher MTV and TLG for HMLs before treatment were identified as worse prognostic parameters in patients with CRLM. The MTV and TLG of 18F-FDG PET/CT could be used as predictors of prognosis.
Authors: Okker D Bijlstra; Maud M E Boreel; Sietse van Mossel; Mark C Burgmans; Ellen H W Kapiteijn; Daniela E Oprea-Lager; Daphne D D Rietbergen; Floris H P van Velden; Alexander L Vahrmeijer; Rutger-Jan Swijnenburg; J Sven D Mieog; Lioe-Fee de Geus-Oei Journal: Diagnostics (Basel) Date: 2022-03-15