PMID- 24516257
OWN - NLM
STAT- MEDLINE
DCOM- 20140429
LR  - 20220408
IS  - 1535-5667 (Electronic)
IS  - 0161-5505 (Linking)
VI  - 55
IP  - 3
DP  - 2014 Mar
TI  - Multifunctional imaging signature for V-KI-RAS2 Kirsten rat sarcoma viral 
      oncogene homolog (KRAS) mutations in colorectal cancer.
PG  - 386-91
LID - 10.2967/jnumed.113.120485 [doi]
AB  - This study explores the potential for multifunctional imaging to provide a 
      signature for V-KI-RAS2 Kirsten rat sarcoma viral oncogene homolog (KRAS) gene 
      mutations in colorectal cancer. METHODS: This prospective study approved by the 
      institutional review board comprised 33 patients undergoing PET/CT before surgery 
      for proven primary colorectal cancer. Tumor tissue was examined histologically 
      for presence of the KRAS mutations and for expression of hypoxia-inducible 
      factor-1 (HIF-1) and minichromosome maintenance protein 2 (mcm2). The following 
      imaging parameters were derived for each tumor: (18)F-FDG uptake ((18)F-FDG 
      maximum standardized uptake value [SUVmax]), CT texture (expressed as mean of 
      positive pixels [MPP]), and blood flow measured by dynamic contrast-enhanced CT. 
      A recursive decision tree was developed in which the imaging investigations were 
      applied sequentially to identify tumors with KRAS mutations. Monte Carlo analysis 
      provided mean values and 95% confidence intervals for sensitivity, specificity, 
      and accuracy. RESULTS: The final decision tree comprised 4 decision nodes and 5 
      terminal nodes, 2 of which identified KRAS mutants. The true-positive rate, 
      false-positive rate, and accuracy (95% confidence intervals) of the decision tree 
      were 82.4% (63.9%-93.9%), 0% (0%-10.4%), and 90.1% (79.2%-96.0%), respectively. 
      KRAS mutants with high (18)F-FDG SUVmax and low MPP showed greater frequency of 
      HIF-1 expression (P = 0.032). KRAS mutants with low (18)F-FDG SUV(max), high MPP, 
      and high blood flow expressed mcm2 (P = 0.036). CONCLUSION: Multifunctional 
      imaging with PET/CT and recursive decision-tree analysis to combine measurements 
      of tumor (18)F-FDG uptake, CT texture, and perfusion has the potential to 
      identify imaging signatures for colorectal cancers with KRAS mutations exhibiting 
      hypoxic or proliferative phenotypes.
FAU - Miles, Kenneth A
AU  - Miles KA
AD  - University College London/UCLH, London, United Kingdom; and.
FAU - Ganeshan, Balaji
AU  - Ganeshan B
FAU - Rodriguez-Justo, Manuel
AU  - Rodriguez-Justo M
FAU - Goh, Vicky J
AU  - Goh VJ
FAU - Ziauddin, Zia
AU  - Ziauddin Z
FAU - Engledow, Alec
AU  - Engledow A
FAU - Meagher, Marie
AU  - Meagher M
FAU - Endozo, Raymondo
AU  - Endozo R
FAU - Taylor, Stuart A
AU  - Taylor SA
FAU - Halligan, Stephen
AU  - Halligan S
FAU - Ell, Peter J
AU  - Ell PJ
FAU - Groves, Ashley M
AU  - Groves AM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140210
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (KRAS protein, human)
RN  - 0 (Proto-Oncogene Proteins)
RN  - EC 3.6.5.2 (Proto-Oncogene Proteins p21(ras))
RN  - EC 3.6.5.2 (ras Proteins)
SB  - IM
MH  - Colorectal Neoplasms/*diagnosis/diagnostic imaging/*genetics
MH  - Decision Trees
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Multimodal Imaging
MH  - *Mutation
MH  - *Positron-Emission Tomography
MH  - Proto-Oncogene Proteins/*genetics
MH  - Proto-Oncogene Proteins p21(ras)
MH  - *Tomography, X-Ray Computed
MH  - ras Proteins/*genetics
OTO - NOTNLM
OT  - KRAS protein
OT  - colonic neoplasms
OT  - comparative study
OT  - diagnostic imaging
OT  - human
EDAT- 2014/02/12 06:00
MHDA- 2014/04/30 06:00
CRDT- 2014/02/12 06:00
PHST- 2014/02/12 06:00 [entrez]
PHST- 2014/02/12 06:00 [pubmed]
PHST- 2014/04/30 06:00 [medline]
AID - jnumed.113.120485 [pii]
AID - 10.2967/jnumed.113.120485 [doi]
PST - ppublish
SO  - J Nucl Med. 2014 Mar;55(3):386-91. doi: 10.2967/jnumed.113.120485. Epub 2014 Feb 
      10.