Abstract
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Objectives To compare response assessment according to the PERCIST1.0, RECIST 1.1, EORTC, and WHO criteria in patients with liver metastases and who had received neoadjuvant chemotherapy to establish the strength of agreement and evaluate therapeutic response between each criteria on PET/CT.
Methods forty one colorectal cancer patients with liver metastases were included in this retrospective study. PET/CT scans were obtained before chemotherapy and after 4-6 cycles’ chemotherapy. The baseline and the sequential follow-up 18FDG PET/ CT of each patient were evaluated according to the PERCIST1.0, RECIST1.1, EORTC, and WHO criteria. The response was categorized into 4 levels according to each criteria: CR (CMR), PR (PMR), SD (SMD), PD (PMD). PET/CT images were used for both metabolic and anatomic evaluation. The concurrent diagnostic CT or MRI images (performed within 1 week of PET/CT) were also utilized when needed. The agreements between each criteria were compared using the κ-statistics and response rate (RR=CR+PR) and disease control rate (DC=CR+PR+SD) were compared using the McNemar test.
Results The response rate and the disease control rate according to the PERCIST1.0 criteria were 31.71% and 63.41%, respectively. The similar ratios (31.71% and 68.29%) were also found for EORTC (κ= 0.9789). The response rate and the disease control rate according to the RECIST1.1 criteria were 17.07% and 60.98%, respectively. The general comparison of PERCIST1.0 and RECIST1.1, EORTC and RECIST1.1 criteria showed good agreements (κ=0.711, κ= 0.6892). Significant statistically difference was not found in the disease control rate(X2 =2.0000, P=0. 0.1573)but found in the response rate(X2 =6.0000, P=0.0143)between PERCIST1.0 and RECIST1.1. The similar result was also found between EORTC and RECIST1.1, the disease control rate(X2 =3.0000, P=0.0833); the response rate(X2 =6.0000, P=0.0143). The response rate and the disease control rate according to the WHO criteria were 12.20% and 70.73%, respectively. And the Significant statistically difference was not found in the disease control rate(X2 =3.0000, P=0. 0.0833)but was found the response rate(X2 =8.0000,P= 0.0047)between PERCIST1.0 and WHO criteria .
Conclusions Our study compared WHO, RECIST 1.1,EORTC, and PERCIST criteria together in the evaluation of treatment response in liver metastases after neoadjuvant chemotherapy. Significant agreement was detected when the anatomical and metabolic criteria were compared both within as well as between each other and the disease control rate under metabolic criteria was significant higher than anatomical criteria.