Predictive role of [18F]FDG PET-CT radiomic parameters for KRAS/BRAF/EGFR mutations in metastatic colorectal cancer patients.

Objective: The objective of this study was to evaluate the predictive value of 18F-fluorodeoxyglucose [18F]FDG positron emission tomography (PET-CT) radiomic parameters in relation to KRAS/BRAF/EGFR mutations in patients with metastatic colorectal cancer (mCRC).

Methods: Blood samples were collected from 90 mCRC patients to assess KRAS G13V, BRAF V600E, and EGFR exon 20 mutations. [18F]FDG PET-CT scans were performed, and radiomic parameters, including the SUV max, max TBR, total MTV, and total TLG, were calculated and correlated with different genotypes and haplotypes of the aforementioned mutations.

Results: The SUV max, TLG, and TBR were significantly greater in patients with the KRAS G13V and BRAF V600E mutations than in patients with the wild-type genotype. The SUVmax was also significantly greater in patients with EGFR exon 20 mutations. Haplotype analysis revealed that the SUVmax was significantly greater in patients with KRAS/BRAF/EGFR mutations than in other patients, with a specificity of 68.18% and sensitivity of 65.28%.

Conclusions: The results suggest that [18F] FDG PET-CT radiomic parameters, particularly the SUV max, have the potential to serve as noninvasive tools for predicting the KRAS/BRAF/EGFR mutation status in mCRC patients.