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Correlation between KRAS mutation and 18F-FDG uptake in stage IV colorectal cancer

 Arthur Cho  ;  Kwanhyeong Jo  ;  Sang Hyun Hwang  ;  Narae Lee  ;  Minkyu Jung  ;  Mijin Yun  ;  Hee Sung Hwang 
 ABDOMINAL RADIOLOGY, Vol.42(6) : 1621-1626, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms/diagnostic imaging* ; Colorectal Neoplasms/genetics* ; Colorectal Neoplasms/pathology ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lung Neoplasms/secondary ; Male ; Middle Aged ; Mutation ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography ; Proto-Oncogene Proteins p21(ras)/genetics* ; Radiographic Image Interpretation, Computer-Assisted ; Radiopharmaceuticals
18F-FDG PET/CT ; KRAS ; Metastatic colorectal cancer
PURPOSE: The purpose of this study is to evaluate the correlation between KRAS mutation, 18F-FDG uptake, and metastatic pattern in advanced stage colorectal cancer (CRC) patients. METHODS: Medical records of stage IV CRC patients who underwent 18F-FDG PET/CT for staging and KRAS mutation analysis were selected. On PET scans, a volume of interest (VOI) was drawn on the primary lesion. 18F-FDG indices (SUVmax, SUVmean, MTV, TLG) of the primary lesions were obtained and correlated with KRAS mutation of the primary lesion. Also, metastatic sites were recorded. Association between metastatic pattern and KRAS expression and FDG indices were analyzed. RESULTS: KRAS mutation was positive in 40 (43%) patients. Evaluation of FDG indices showed that higher SUVmax (14.0 vs. 11.2, p = 0.004), higher SUVmean (5.3 vs. 4.7, p = 0.005), and higher TLG (301.4 vs. 205.5, p = 0.023) were predictive of KRAS mutation compared to wild-type (WT) KRAS. Lung metastasis was more frequently involved in patients with KRAS mutation (50.0% vs. 22.6%, p = 0.006), and liver metastasis was more frequently involved in patients with WT KRAS (81.1% vs. 55.0%, p = 0.007). Multivariate analysis showed that primary tumor location (OR 3.92, p = 0.07) and KRAS mutation (OR 2.45, p = 0.09) were significant factors in lung metastasis model. CONCLUSION: KRAS mutation patients had more frequent lung metastasis and had higher 18F-FDG uptake compared to WT KRAS in stage IV CRC.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Na Rae(이나래)
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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