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KMID : 1148920230570050223
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Nuclear Medicine and Molecular Imaging
2023 Volume.57 No. 5 p.223 ~ p.234
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Contribution of Metabolic Parameters and Pericolic Fat Stranding on Preoperative 18F-FDG PET/CT in Predicting Post-operative Histopathology and Outcome in Colorectal Cancer
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Selin Soyluoglu
Busra Ozdemir Gunay
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Abstract
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Purpose : We aimed to investigate the additional value of preoperative PET/CT and reveal relationships between metabolic parameters, pericolic fat stranding finding, postoperative histopathology, and overall survival in colorectal cancer (CRC).
Methods : CRC patients who underwent preoperative PET/CT between January 2017-December 2021 were analyzed. Lymph nodes, organ metastases, and metabolic parameters were evaluated from PET/CT. The pericolic fat stranding was evaluated from CT component. Relationships between these factors and postoperative histopathological findings were statistically analyzed. Survival analyses were performed.
Results : Ninety-one patients (59 males, 32 females) were included in the study. All tumors showed high FDG uptake (mean SUVmax 19.5?±?9.9). SUVmax of the tumor differed significantly at T3 and T4 stages (p?=?0.041). A significant correlation was found between MTV, TLG values and the differentiation degree (p?=?0.005, 0.003, respectively). PET/CT predicted the N stage with a high accuracy rate (80%). PET/CT found additional metastases that changed treatment decisions in one-third of patients. A relationship was found between tumor length, surgical margin, lymphovascular invasion and pericolic fat stranding. In multivariate analysis, differentiation degree (HR?=?26.1, 95%CI 1.672?408.467), MTV (HR?=?0.3, 95%CI 0.071?0.841), TLG (HR?=?3.5, 95%CI 1.065?11.193), and lymphovascular invasion (HR?=?0.2, 95%CI 0.026?0.853, p?=?0.033) were independent factors affecting overall survival.
Conclusion : Preoperative PET/CT contributes to CRC management by detecting additional metastases as well as predicting prognosis and postoperative findings such as T stage, N stage and tumor differentiation. The SUVmax may differentiate between T3 and T4 tumor. Reporting of pericolic fat stranding may contribute to the estimation of lymphatic invasion and positive surgical margin.
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KEYWORD
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F-18-FDG PET, PET/CT, FDG, Colorectal cancer, Colon cancer, Pericolic fat stranding
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