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Value of DCE-MRI and FDG-PET/CT in the prediction of response to preoperative chemotherapy with bevacizumab for colorectal liver metastases

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De Bruyne, Sylvie Van Damme, Nancy Smeets, Peter Ferdinande, Liesbeth Ceelen, Wim Libbrecht, Louis [UCL] Peeters, Marc

BACKGROUND: The purpose of this study was to assess the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and (18)F-fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) for evaluation of response to chemotherapy and bevacizumab and for prediction of progression-free survival (PFS) in patients with metastatic colorectal cancer (mCRC) with potentially resectable liver lesions. METHODS: A total of 19 mCRC patients were treated with FOLFOX/FOLFIRI and bevacizumab followed by surgery. Dynamic contrast-enhanced magnetic resonance imaging and FDG-PET/CT were performed before treatment and after cycle 5. PET results were quantified by calculating maximum standardised uptake value (SUV(max)) whereas area under the enhancement curve (AUC), initial AUC (iAUC) and the endothelial transfer constant (K(trans)) were used to quantify DCE-MRI. Pathological analysis of the resection specimen was performed, including measurement of microvessel density (MVD) and proliferation index. RESULTS: Both AUC and iAUC were significantly decreased following bevacizumab therapy (median change of 22% (P=0.002) and 40% (P=0.001) for AUC and iAUC, respectively). Progression-free survival benefit was shown for patients with >40% reduction in K(trans) (P=0.019). In the group of radiological responders, the median baseline SUV(max) was 3.77 (IQR: 2.88-5.60) compared with 7.20 (IQR: 4.67-8.73) in nonresponders (P=0.021). A higher follow-up SUV(max) was correlated with worse PFS (P=0.012). Median MVD was 10.9. Progression-free survival was significantly shorter in patients with an MVD greater than 10, compared with patients with lower MVD (10 months compared with 16 months, P=0.016). CONCLUSION: High relative decrease in K(trans), low follow-up SUV(max) and low MVD are favourable prognostic factors for mCRC patients treated with bevacizumab before surgery.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2012
Language Anglais
Journal information "The British journal of cancer" - Vol. 106, no.12, p. 1926-1933 (2012)
Peer reviewed yes
Publisher Nature Publishing Group ((United Kingdom) London)
issn 0007-0920
e-issn 1532-1827
Publication status Publié
Affiliation [UGent]
MESH Subject Antibodies, Monoclonal, Humanized ; Humans ; Leucovorin ; Liver Neoplasms ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multimodal Imaging ; Neoadjuvant Therapy ; Organoplatinum Compounds ; Positron-Emission Tomography ; Antineoplastic Combined Chemotherapy Protocols ; Tomography, X-Ray Computed ; Bevacizumab ; Camptothecin ; Colorectal Neoplasms ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Fluorouracil
Keywords Bevacizumab ; Colorectal cancer ; DCE-MRI ; FDG-PET/CT ; Immunohistochemistry ; Liver metastases
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Bibliographic reference De Bruyne, Sylvie ; Van Damme, Nancy ; Smeets, Peter ; Ferdinande, Liesbeth ; Ceelen, Wim ; et. al. Value of DCE-MRI and FDG-PET/CT in the prediction of response to preoperative chemotherapy with bevacizumab for colorectal liver metastases. In: The British journal of cancer, Vol. 106, no.12, p. 1926-1933 (2012)
Permanent URL http://hdl.handle.net/2078/187563