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Metabolic Imaging Phenotype Using Radiomics of [18F]FDG PET/CT Associated with Genetic Alterations of Colorectal Cancer

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Abstract

Purpose

To understand the association between genetic mutations and radiomics of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission tomography (PET)/x-ray computed tomography (CT) in patients with colorectal cancer (CRC).

Procedures

This study included 74 CRC patients who had undergone preoperative [18F]FDG PET/CT. A total of 65 PET/CT-related features including intensity, volume-based, histogram, and textural features were calculated. High-resolution melting methods were used for genetic mutation analysis.

Results

Genetic mutants were found in 21 KRAS tumors (28 %), 31 TP53 tumors (42 %), and 17 APC tumors (23 %). Tumors with a mutated KRAS had an increased value at the 25th percentile of maximal standardized uptake value (SUVmax) within their metabolic tumor volume (MTV) (P < .0001; odds ratio [OR] 1.99; 95 % confidence interval [CI] 1.37–2.90) and their contrast from the gray-level cooccurrence matrix (P = .005; OR 1.52; 95 % CI 1.14–2.04). A mutated TP53 was associated with an increased value of short-run low gray-level emphasis derived from the gray-level run length matrix (P = .001; OR 243006.0; 95 % CI 59.2–996,872,313). APC mutants exhibited lower low gray-level zone emphasis derived from the gray-level zone length matrix (P = .006; OR < .0001; 95 % CI 0.000–0.22).

Conclusion

PET/CT-derived radiomics can provide supplemental information to determine KRAS, TP53, and APC genetic alterations in CRC.

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Acknowledgments

This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004), China Medical University Hospital; Academia Sinica Stroke Biosignature Project (BM10701010021); MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-); Tseng-Lien Lin Foundation, Taichung, Taiwan; and Katsuzo and Kiyo Aoshima Memorial Funds, Japan, China Medical University Hospital (CRS-106-039, CRS-106-041). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study.

Author information

Author notes

  1. Shang-Wen Chen, Wei-Chih Shen, Jan-Gowth Chang and Chia-Hung Kao contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan

    Shang-Wen Chen

  2. Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    Shang-Wen Chen, William Tzu-Liang Chen, Jan-Gowth Chang & Chia-Hung Kao

  3. Department of Radiology, School of Medicine, Taipei Medical University, Taipei, Taiwan

    Shang-Wen Chen

  4. Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan

    Wei-Chih Shen

  5. Department of Surgery, China Medical University Hospital, Taichung, Taiwan

    William Tzu-Liang Chen

  6. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

    Te-Chun Hsieh, Kuo-Yang Yen & Chia-Hung Kao

  7. Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan

    Te-Chun Hsieh & Kuo-Yang Yen

  8. Department of Laboratory Medicine, Chine Medical University Hospital, Taichung, Taiwan

    Jan-Gowth Chang

  9. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan

    Chia-Hung Kao

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Contributions

All authors have contributed substantially to, and are in agreement with the content of, the manuscript: conception/design: Shang-Wen Chen, Chia-Hung Kao; provision of study materials: Chia-Hung Kao, Jan-Gowth Chang; collection and/or assembly of data: Shang-Wen Chen, Wei-Chih Shen, William Tzu-Liang Chen, Te-Chun Hsieh, Kuo-Yang Yen, Jan-Gowth Chang, Chia-Hung Kao; data analysis and interpretation: Shang-Wen Chen, Wei-Chih Shen, William Tzu-Liang Chen, Te-Chun Hsieh, Kuo-Yang Yen, Jan-Gowth Chang, Chia-Hung Kao; manuscript preparation: Shang-Wen Chen, Wei-Chih Shen, William Tzu-Liang Chen, Te-Chun Hsieh, Kuo-Yang Yen, Jan-Gowth Chang, Chia-Hung Kao; final approval of manuscript: Shang-Wen Chen, Wei-Chih Shen, William Tzu-Liang Chen, Te-Chun Hsieh, Kuo-Yang Yen, Jan-Gowth Chang, Chia-Hung Kao. The guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article: Chia-Hung Kao.

Corresponding author

Correspondence to Chia-Hung Kao.

Ethics declarations

The study was approved by the local institutional review board (certificate numbers CMUH102-REC2-74 and DMR99-IRB-010-1).

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

The IRB also specifically waived the consent requirement.

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Chen, SW., Shen, WC., Chen, W.TL. et al. Metabolic Imaging Phenotype Using Radiomics of [18F]FDG PET/CT Associated with Genetic Alterations of Colorectal Cancer. Mol Imaging Biol 21, 183–190 (2019). https://doi.org/10.1007/s11307-018-1225-8

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