Abdullah Özgür YENİOVA, Metin UZMAN, Özlem ÖZMEN, Gülçin ŞİMŞEK, Servet GÜREŞCİ, Ebru TATCI, Atila GÖKÇEK

Correlation of Ki-67 proliferation index and 18-fluorodeoxyglucose uptake in colorectal incidental lesions detected by positron emission tomography-computed tomography

Background/aim: To investigate whether focal high maximum standardized uptake value (SUVmax) determined by 18-fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT) imaging is correlated with proliferation index in the colorectal region. Materials and methods: SUVmax values of 31 colorectal neoplasms that were incidentally detected during PET-CT examination were compared to dysplasia degree, histopathologic diagnosis, and immunohistochemical expression of the Ki-67 proliferation marker. Results: Statistically significant correlations were found between SUVmax and Ki-67 proliferation index, dysplasia degree, and histopathologic diagnosis. Median SUVmax value was found to be significantly higher in high-risk lesions than low-risk lesions. Conclusion: The Ki-67 proliferation index is an indicator of SUVmax in colorectal tract. SUVmax values can predict malignancy and prognosis in this region. Colonoscopy and biopsy should always be performed whenever a focal high FDG uptake is determined incidentally in a patient.

PDF

___

1. Esteves FP, Schuster DM, Halkar KR. Gastrointestinal tract malignancies and positron emission tomography: an overview. Semin Nucl Med 2006; 36: 169-181.
2. OConnor OJ, McDermott S, Slattery J, Sahani D, Blake MA. The use of PET-CT in the assesment of patients with colorectal carcinoma. Int J Surg Oncol 2011; 2011: 846512.
3. Odze RD, Riddel RH, Bosman FT. Premalignant lesions of the digestive system. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumors of the Digestive System. 4th ed. Lyon, France: IARC; 2010. pp. 10-12.
4. Hong R, Lim SC. 18-F-fluoro-2-deoxyglucose uptake on PET CT and glucose transporter 1 expression in colorectal adenocarcinoma. World J Gastroenterol 2012; 18: 168-174.
5. Brown DC, Gatter GC. Ki 67 protein: the immaculate deception? Histopathology 2002; 40: 2-11.
6. Tchou J, Sonnad SS, Bergey MR, Basu S, Tomaszewski J, Alavi A, Schnall M. Degree of tumor FDG uptake correlates with proliferation index in triple negative breast cancer. Mol Imag Biol 2010; 12: 657-662.
7. Shou Y, Lu S, Chen T, Ma D, Tong L. Correlation of fluorodeoxyglucose uptake and tumor proliferating antigen Ki-67 in lymphomas. J Can Res Ther 2012; 8: 96-102.
8. Lumachi F, Orlando F, Marino F, Chiara GB, Basso SM. Expression of p53 and Ki-67 as prognostic factors for survival of men with colorectal cancer. Anticancer Res 2012; 32: 3965- 3967.
9. He Z, Shi C, Wen H, Li F, Wang B, Wang J. The potential of carcinoembryonic antigen, p53, Ki-67 and glutathione S transferase-π as clinico-histopathological markers for colorectal cancer.J Biomed Res 2010; 24: 51-57.
10. Riedl CC, Akhurst T, Larson S, Stanziale SF, Tuorto S, Bhargava A, Hricak H, Klimstra D, Fong Y. 18-F-FDG PET scanning correlates with tissue markers of poor prognosis and predicts mortality for patients after liver resection for colorectal metastases. J Nucl Med 2007; 48: 771-775.
11. Lee JE, Kim SW, Kim JS, Choi KY, Kang WK, Oh ST, Yoo IR, Kim SH. Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer. World J Gastroenterol 2012; 18: 5072-5077.
12. Konishi K, Morson BC. Pathology of colorectal adenomas: a colonoscopic survey. J Clin Pathol 1982; 35: 830-841.
13. Van Kouwen MC, Nagengast FM, Jansen JB, Oyen WJ, Drenth JP. 2-(18F)-Fluoro-2-deoxy-D-glucose positron emission tomography detects clinical relevant adenomas of the colon: a prospective study. J Clin Oncol 2005; 23: 3713-3717.
14. Chen YK, Kao CH, Liao AC, Shen YY, Su CT. Colorectal cancer screening in asymptomatic adults: the role of FDG PET scan. Anticancer Res 2003; 23: 4357-4361.
15. Gutman F, Alberini JL, Wartski M, Vilian D, Le Stanc E, Sarandi F, Corone C, Tainturier C, Pecking AP. Incidental colonic focal lesions detected by FDG PET/CT. Am J Roentgenol 2005; 185: 495-500.
16. Peng J, He Y, Xu J, Sheng J, Cai S, Zhang Z. Detection of incidental colorectal tumors with 18F-labelled 2-fluoro-2-deoxyglucose positron emission tomography /computed tomography scans: results of a prospective study. Colorectal Dis 2011; 13: 374-378.
17. Oh JR, Min JJ, Song HC, Chong A, Kim GE, Choi C, Seo JH, Bom HS. A stepwise approach using metabolic volume and SUVmax to differentiate malignancy and dysplasia from benign colonic uptakes on 18F-FDG PET/CT. Clin Nuc Med 2012; 37: 134-140.
18. Weston BR, Iyer RB, Qiao W, Lee JH, Bresalier RS, Ross WA. Ability of integrated positron emission and computed tomography to detect significant colonic pathology. Cancer 2010; 116: 1454-1461.
19. Israel O, Yefremov N, Bar-Shalom R, Kagana O, Frenkel A, Keidar Z, Fischer D. PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localisation patterns and clinical significance. J Nucl Med 2005; 46: 758- 762.
20. Kei PL, Vikram R, Yeung HWD, Stroehlein JR, Macapinlac HA. İncidental finding of focal FDG uptake in bowel during PET/CT: CT features and correlation with histopathologic results. Am J Roentgenol 2010; 194: 401-406.
21. Treglia G, Calcagni ML, Rufini V, Leccisotti L, Meduri GM, Spitilli MG, Dambra DP, De Gaetano AM, Giordano A. Clinical significance of incidental focal colorectal 18F-fluorodeoxyglucose uptake: our experience and a review of the literature. Colorectal Dis 2012; 14: 174-180.