• Colorectal Liver Metastasis After 90Y Radioembolization Therapy: Pilot Study of Change in MDCT Attenuation as a Surrogate Marker for Future FDG PET Response

    AJR:198, May 2012

    Sandra M.Tochetto Hüseyin GürkanTöre Hamid Chalian Vahid Yaghmai

    OBJECTIVE. The purpose of this study was to investigate whether changes in attenua­tion and size of liver metastatic lesions of colorectal cancer at MDCT 1 month after 90Y ra­dioembolization treatment are predictive of response at FDG PET 3 months after treatment.

    MATERIALS AND METHODS. Twenty patients with colorectal liver metastasis con­secutively treated with 90Y radioembolization underwent triphasic MDCT of the liver at base­line and 1 and 3 months after treatment and FDG PET at baseline and 3 months after treat­ment. Percentage change in tumor attenuation at MDCT (volumetric attenuation), tumor size at MDCT (according to Response Evaluation Criteria in Solid Tumors [RECIST] and World health Organization [WHO] criteria), and volume-weighted maximum standardized uptake value at FDG PET were evaluated. The correlation between FDG PET response 3 months af­ter treatment and response according to RECIST, WHO criteria, and attenuation 1 month af­ter treatment was evaluated.

    RESULTS. Only 13.3% of patients with FDG PET findings of response 3 months after treatment were identified according to RECIST and WHO criteria 1 month after treatment. According to attenuation criteria at 1 month, however, 53.3% of patients with an FDG PET response at 3 months were identified. A strong association was found between FDG PET re­sponse at 3 months and response based on attenuation criteria (odds ratio, 12.4; 95% CI, 0.58-265.3; p = 0.05).

    CONCLUSION. Early changes in the attenuation of liver metastatic lesions of colon can­cer after 90Y radioembolization treatment may be predictive of future response at FDG PET.