Ming Young Simon Wan MBBChir, Abstract Co-Author: Nothing to Disclose

Balaji Ganeshan PhD, Presenter: Scientific Director, TexRAD Limited

Alec Engledow, Abstract Co-Author: Nothing to Disclose

Daren Francis, Abstract Co-Author: Nothing to Disclose

Nick Reay-Jones, Abstract Co-Author: Nothing to Disclose

Manuel Rodriguez-Justo, Abstract Co-Author: Nothing to Disclose

Marie Meagher, Abstract Co-Author: Nothing to Disclose

Jacquie Peck, Abstract Co-Author: Nothing to Disclose

Kim Jaggs, Abstract Co-Author: Nothing to Disclose

Helen Whiteway, Abstract Co-Author: Nothing to Disclose

Jackie Hayward, Abstract Co-Author: Nothing to Disclose

Zia Saad, Abstract Co-Author: Nothing to Disclose

Faira Rizal, Abstract Co-Author: Nothing to Disclose

Jakub Nalepa, Abstract Co-Author: Contract, TexRAD Limited Contract, Cambridge Computed Imaging Ltd

Michael Hayball, Abstract Co-Author: Director, TexRAD Limited Director, Cambridge Computed Imaging Ltd

Robert Kozarski, Abstract Co-Author: Nothing to Disclose

Peter Josef Ell MD, Abstract Co-Author: Consultant, Ion Beam Applications, SA

Stuart Andrew Taylor MBBS, Abstract Co-Author: Nothing to Disclose

Steve Halligan MD, Abstract Co-Author: Research Consultant, iCAD, Inc

Kenneth Miles, Abstract Co-Author: Shareholder, TexRAD Limited

Ashley McAllister Groves MBBS, Abstract Co-Author: Investigator, GlaxoSmithKline plc Investigator, General Electric Company Investigator, Siemens AG

We investigated the prognostic value of FDG PET and CT texture analysis for survival of colorectal cancer patients grouped by stage as a) stage I-III rectal cancer, b) stage I-III colonic cancer and c)metastatic stage IV.

126 patients (79-males; 47-females; mean-age 66.2±10.6y) with primary colorectal cancer prospectively underwent FDG-PET/CT. Primary tumour heterogeneity was assessed on CT images using image filtration-histogram technique. FDG uptake (SUVmax) on PET was measured. Clinical stage was determined using surgical histology and clinical imaging data. Univariate Kaplan-Meier analysis assessed the ability of each imaging and clinical markers to predict survival. Cross-validation assessed the prognostic model via hazard ratio. Multivariate Cox’s regression was used to test the independence of significant model input factors. Institutional Review Board approval was obtained.

Median follow up for surviving patients was 47.9 months (minimum 12 months). For patients with stage I-III rectal cancer (n=42), CTTA (coarse skewness, p=0.011), SUVmax (p=0.012) and clinical stage (p=0.006) were the best survival predictors. A significant interaction between skewness and clinical stage was the only independent predictor (p=0.003). For patients with stage I-II (n=28) and stage III (n=28) colon cancer, CTTA (unfiltered kurtosis, p=0.001) and T-stage respectively were the only significant survival predictors. CTTA (fine kurtosis) was the only significant survival predictor in stage IVb disease (n=11).

Tumour heterogeneity measured as CTTA and glucose uptake on PET were found to be survival predictors for colorectal cancer patients divided in a number of clinically relevant sub-populations.

CT textural features and FDG signal has potential to predict survival and help refine management decision in colorectal cancer patients at staging, in a number of clinically relevant settings.

Wan, M, Ganeshan, B, Engledow, A, Francis, D, Reay-Jones, N, Rodriguez-Justo, M, Meagher, M, Peck, J, Jaggs, K, Whiteway, H, Hayward, J, Saad, Z, Rizal, F, Nalepa, J, Hayball, M, Kozarski, R, Ell, P, Taylor, S, Halligan, S, Miles, K, Groves, A, PETCT Derived Tumoural Heterogeneity and Glucose Uptake Predicts Survival in Primary Colorectal Cancer Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018326.html