Metabolic Imaging Phenotype Using Radiomics of [ 18 F]FDG PET/CT Associated with Genetic Alterations of Colorectal Cancer

Purpose: To understand the association between genetic mutations and radiomics of 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) positron emission tomography (PET)/x-ray computed tomography (CT) in patients with colorectal cancer (CRC). Procedures: This study included 74 CRC patients who had undergone preoperative [ 18 F]FDG PET/CT. A total of 65 PET/CT-related features including intensity, volume-based, histogram, and textural features were calculated. High-resolution melting methods were used for genetic mutation analysis. Results: Genetic mutants were found in 21 KRAS tumors (28 %), 31 TP53 tumors (42 %), and 17 APC tumors (23 %). Tumors with a mutated KRAS had an increased value at the 25th percentile of maximal standardized uptake value (SUV max ) within their metabolic tumor volume (MTV) (P <.0001; odds ratio [OR] 1.99; 95 % confidence interval [CI] 1.37–2.90) and their contrast from the gray-level cooccurrence matrix (P =.005; OR 1.52; 95 % CI 1.14–2.04). A mutated TP53 was associated with an increased value of short-run low gray-level emphasis derived from the gray-level run length matrix (P =.001; OR 243006.0; 95 % CI 59.2–996,872,313). APC mutants exhibited lower low gray-level zone emphasis derived from the gray-level zone length matrix (P =.006; OR <.0001; 95 % CI 0.000–0.22). Conclusion: PET/CT-derived radiomics can provide supplemental information to determine KRAS, TP53, and APC genetic alterations in CRC.