Title : Predictive role of [18F] FDG PET-CT radiomic parameters for KRAS/BRAF/EGFR mutations in metastatic colorectal cancer patients
Abstract:
Background: KRAS, BRAF, and EGFR mutations are critical in the prognosis and treatment response of metastatic colorectal cancer (mCRC). Identifying these mutations noninvasively could enhance patient stratification and therapeutic decision-making.
Purpose: This study evaluates the predictive value of 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET-CT) radiomic parameters in detecting KRAS G13V, BRAF V600E, and EGFR exon 20 mutations in mCRC patients.
Methodology/Approach: 90 mCRC patients underwent blood testing to assess KRAS, BRAF, and EGFR mutations. [18F]FDG PET-CT scans were performed to extract radiomic parameters, including SUVmax, max TBR, total MTV, and total TLG. These parameters were analyzed for correlations with different genotypes and haplotypes.
Findings/Conclusions: SUVmax, TLG, and TBR values were significantly higher in patients with KRAS G13V and BRAF V600E mutations than in those with the wild-type genotype. SUVmax was also significantly elevated in patients with EGFR exon 20 mutations. Haplotype analysis confirmed that SUVmax was significantly higher in patients harboring KRAS/BRAF/EGFR mutations, with a specificity of 68.18% and a sensitivity of 65.28%. These findings suggest that SUVmax could serve as a noninvasive biomarker for genetic profiling in mCRC.
Implications: Radiomic analysis of [18F] FDG PET-CT images can improve early mutation detection in mCRC, aiding in personalized treatment strategies. Future research should validate these findings in larger cohorts and explore their clinical applications.
