Surrogate imaging biomarkers of response of colorectal liver metastases after salvage radioembolization using (90)Y-loaded resin microspheres Journal Article


Authors: Shady, W.; Sotirchos, V. S.; Do, R. K.; Pandit-Taskar, N.; Carrasquillo, J. A.; Gonen, M.; Sofocleous, C. T.
Article Title: Surrogate imaging biomarkers of response of colorectal liver metastases after salvage radioembolization using (90)Y-loaded resin microspheres
Abstract: OBJECTIVE. The purpose of the present study is to evaluate Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, tumor attenuation criteria, Choi criteria, and European Organization for Research and Treatment of Cancer (EORTC) PET criteria as measures of response and subsequent predictors of liver progression-free survival (PFS) after radioembolization (RE) of colorectal liver metastases (CLM). The study also assesses interobserver variability for measuring tumor attenuation using a single 2D ROI on a simple PACS workstation. MATERIALS AND METHODS. We performed a retrospective review of the clinical RE database at our institution, to identify patients treated in the salvage setting for CLM between December 2009 and March 2013. Response was evaluated on FDG PET scans, with the use of EORTC PET criteria, and on portal venous phase CT scans, with the use of RECIST 1.1, tumor attenuation criteria, and Choi criteria. Two independent blinded observers measured tumor attenuation using a single 2D ROI. The intraclass correlation coefficient (ICC) for interobserver variability was assessed. Kaplan-Meier methodology was used to calculate liver PFS, and the log-rank test was used to assess the response criteria as predictors of liver PFS. RESULTS. A total of 25 patients with 46 target tumors were enrolled in the study. The ICC was 0.95 at baseline and 0.98 at response evaluation. Among the 25 patients, more responders (i.e., partial response) were identified on the basis of EORTC PET criteria (n = 14), Choi criteria (n = 15), and tumor attenuation criteria (n = 13) than on the basis of RECIST 1.1 (n = 2). The median liver PFS was 3.0 months (95% CI, 2.1-4.0 months). Response identified on the basis of EORTC PET criteria (p < 0.001), Choi criteria (p < 0.001), or tumor attenuation criteria (p = 0.01) predicted liver PFS; however, response identified by RECIST 1.1 did not (p = 0.1). CONCLUSION. RECIST 1.1 has poor sensitivity for detecting metabolic responses classified by EORTC PET criteria. EORTC PET criteria, Choi criteria, and tumor attenuation criteria appear to be equally reliable surrogate imaging biomarkers of liver PFS after RE in patients with CLM. © American Roentgen Ray Society.
Keywords: colorectal liver metastases; radioembolization; choi criteria; tumor attenuation
Journal Title: American Journal of Roentgenology
Volume: 207
Issue: 3
ISSN: 0361-803X
Publisher: American Roentgen Ray Society  
Date Published: 2016-09-01
Start Page: 661
End Page: 670
Language: English
DOI: 10.2214/ajr.15.15202
PROVIDER: scopus
PUBMED: 27384594
PMCID: PMC5675077
DOI/URL:
Notes: Article -- Export Date: 1 September 2016 -- Source: Scopus
Altmetric
Citation Impact
MSK Authors
  1. Mithat Gonen
    780 Gonen
  2. Kinh Gian Do
    145 Do
  3. Waleed   Shady
    10 Shady