The prognostic value of 18FFDG PET/CT texture analysis prior to transplantation for unresectable colorectal liver metastases

Abstract Introduction To determine whether heterogeneity in colorectal liver metastases (CRLM) 18 F fluorodeoxyglucose 18 FFDG distribution is predictive of disease‐free survival (DFS) and overall survival (OS) following liver transplantation (LT) for unresectable CRLM. Methods The preoperative 18 FFDG positron emission tomography/computed tomography examinations of all patients in the secondary cancer 1 and 2 studies were retrospectively assessed. Maximum standardized uptake value (SUV max ), metabolic tumour volume (MTV), and six texture heterogeneity parameters (joint entropy GLCM, dissimilarity GLCM, grey level variance SZM, size zone variance SZM, and zone percentage SZM , and morphological feature convex deficiency) were obtained. DFS and OS for patients over and under the median value for each of these parameters were compared by using the Kaplan Meier method and log rank test. Results Twenty‐eight out of 40 patients who underwent LT for unresectable CRLM had liver metastases with uptake above liver background and were eligible for inclusion. Low MTV ( p < 0.001) and dissimilarity GLCM ( p = 0.016) were correlated to longer DFS. Low MTV ( p < 0.001) and low values of the texture parameters dissimilarity GLCM ( p = 0.038), joint entropy GLCM ( p = 0.015) and zone percentage SZM ( p = 0.037) were significantly correlated to longer OS. SUV max was not correlated to DFS and OS. Conclusion Although some texture parameters were able to significantly predict DFS and OS, MTV seems to be superior to predict both DFS and OS following LT for unresectable CRLM.