Eddiel Cruz-Hernández1, Usman Mahmood2, Jennifer S Golia Pernicka3, Viktoriya Paroder3, Iva Petkovska3, Marc J Gollub3, Jinru Shia4, Karuna Ganesh5, David D B Bates3. 1. Ponce Health Sciences University, Ponce, Puerto Rico. 2. Department of Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 3. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 4. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Molecular Pharmacology Program and Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Abstract
BACKGROUND: To evaluate quantitative iodine parameters from the arterial phase dual-energy computed tomography (DECT) scans as an imaging biomarker for tumor grade (TG), mitotic index (MI), and Ki-67 proliferation index of hepatic metastases from neuroendocrine tumors (NETs) of the gastrointestinal (GI) tract. Imaging biomarkers have the potential to provide relevant clinical information about pathologic processes beyond lesion morphology. NETs are a group of rare, heterogeneous neoplasms classified by World Health Organization (WHO) TG, which is derived from MI and Ki-67 proliferation index. Imaging biomarkers for these pathologic features and TG may be useful. METHODS: Between January 2014 and April 2019, 73 unique patients with hepatic metastases from NET of the GI tract underwent DECT of the abdomen with an arterial phase were analyzed after exclusions. Using GSIViewer software (GE Healthcare, Madison, Wisconsin), elliptical regions of interest (ROIs) were placed over selected hepatic metastases by a fellowship trained abdominal radiologist. Quantitative iodine concentration (IC) data was extracted from the lesion ROIs, and the normalized IC (lesion IC/aorta IC) and relative IC (lesion IC/liver IC) for each liver were calculated. Spearman correlation was calculated for lesion mean IC, normalized IC, and relative IC to both Ki-67 proliferation and mitotic indices. Student's t-test was performed to compare lesion mean IC, normalized IC and relative IC between WHO TGs. RESULTS: There was very weak correlation between both normalized IC and relative IC for both Ki-67 proliferation and mitotic indices. A significant difference was not observed between normalized IC and relative IC to distinguish metastases from G1 and G2/3 tumors. CONCLUSIONS: Our study finds limited potential for quantitative parameters from DECT to distinguish neuroendocrine hepatic metastases by WHO TG, as well as limited potential as an imaging biomarker for Ki-67 proliferation and mitotic indices in this setting. Our findings of a lack of correlation between Ki-67 and quantitative iodine parameters stands in contrast to existing literature that reports positive correlations for these parameters in the rectum and stomach. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: To evaluate quantitative iodine parameters from the arterial phase dual-energy computed tomography (DECT) scans as an imaging biomarker for tumor grade (TG), mitotic index (MI), and Ki-67 proliferation index of hepatic metastases from neuroendocrine tumors (NETs) of the gastrointestinal (GI) tract. Imaging biomarkers have the potential to provide relevant clinical information about pathologic processes beyond lesion morphology. NETs are a group of rare, heterogeneous neoplasms classified by World Health Organization (WHO) TG, which is derived from MI and Ki-67 proliferation index. Imaging biomarkers for these pathologic features and TG may be useful. METHODS: Between January 2014 and April 2019, 73 unique patients with hepatic metastases from NET of the GI tract underwent DECT of the abdomen with an arterial phase were analyzed after exclusions. Using GSIViewer software (GE Healthcare, Madison, Wisconsin), elliptical regions of interest (ROIs) were placed over selected hepatic metastases by a fellowship trained abdominal radiologist. Quantitative iodine concentration (IC) data was extracted from the lesion ROIs, and the normalized IC (lesion IC/aorta IC) and relative IC (lesion IC/liver IC) for each liver were calculated. Spearman correlation was calculated for lesion mean IC, normalized IC, and relative IC to both Ki-67 proliferation and mitotic indices. Student's t-test was performed to compare lesion mean IC, normalized IC and relative IC between WHO TGs. RESULTS: There was very weak correlation between both normalized IC and relative IC for both Ki-67 proliferation and mitotic indices. A significant difference was not observed between normalized IC and relative IC to distinguish metastases from G1 and G2/3 tumors. CONCLUSIONS: Our study finds limited potential for quantitative parameters from DECT to distinguish neuroendocrine hepatic metastases by WHO TG, as well as limited potential as an imaging biomarker for Ki-67 proliferation and mitotic indices in this setting. Our findings of a lack of correlation between Ki-67 and quantitative iodine parameters stands in contrast to existing literature that reports positive correlations for these parameters in the rectum and stomach. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Authors: Carlo N De Cecco; Daniel T Boll; David N Bolus; W Dennis Foley; Ravi K Kaza; Desiree E Morgan; Neil M Rofsky; Dushyant V Sahani; U Joseph Schoepf; William P Shuman; Marilyn J Siegel; Terri J Vrtiska; Benjamin M Yeh; Lincoln L Berland Journal: J Comput Assist Tomogr Date: 2017-01 Impact factor: 1.826
Authors: Thomas A Hope; Marc J Gollub; Supreeta Arya; David D B Bates; Dhakshinamoorthy Ganeshan; Mukesh Harisinghani; Kartik S Jhaveri; Zahra Kassam; David H Kim; Elena Korngold; Neeraj Lalwani; Courtney C Moreno; Stephanie Nougaret; Viktoriya Paroder; Raj M Paspulati; Jennifer S Golia Pernicka; Iva Petkovska; Perry J Pickhardt; Gaiane M Rauch; Michael H Rosenthal; Shannon P Sheedy; Natally Horvat Journal: Abdom Radiol (NY) Date: 2019-11
Authors: James P B O'Connor; Eric O Aboagye; Judith E Adams; Hugo J W L Aerts; Sally F Barrington; Ambros J Beer; Ronald Boellaard; Sarah E Bohndiek; Michael Brady; Gina Brown; David L Buckley; Thomas L Chenevert; Laurence P Clarke; Sandra Collette; Gary J Cook; Nandita M deSouza; John C Dickson; Caroline Dive; Jeffrey L Evelhoch; Corinne Faivre-Finn; Ferdia A Gallagher; Fiona J Gilbert; Robert J Gillies; Vicky Goh; John R Griffiths; Ashley M Groves; Steve Halligan; Adrian L Harris; David J Hawkes; Otto S Hoekstra; Erich P Huang; Brian F Hutton; Edward F Jackson; Gordon C Jayson; Andrew Jones; Dow-Mu Koh; Denis Lacombe; Philippe Lambin; Nathalie Lassau; Martin O Leach; Ting-Yim Lee; Edward L Leen; Jason S Lewis; Yan Liu; Mark F Lythgoe; Prakash Manoharan; Ross J Maxwell; Kenneth A Miles; Bruno Morgan; Steve Morris; Tony Ng; Anwar R Padhani; Geoff J M Parker; Mike Partridge; Arvind P Pathak; Andrew C Peet; Shonit Punwani; Andrew R Reynolds; Simon P Robinson; Lalitha K Shankar; Ricky A Sharma; Dmitry Soloviev; Sigrid Stroobants; Daniel C Sullivan; Stuart A Taylor; Paul S Tofts; Gillian M Tozer; Marcel van Herk; Simon Walker-Samuel; James Wason; Kaye J Williams; Paul Workman; Thomas E Yankeelov; Kevin M Brindle; Lisa M McShane; Alan Jackson; John C Waterton Journal: Nat Rev Clin Oncol Date: 2016-10-11 Impact factor: 66.675