Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients with Pancreatic Cancer
Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients with Pancreatic Cancer
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DOI：
10.2967/jnumed.113.131847
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发表时间：
2014-06-01
影响因子：
9.3
通讯作者：
Lee, Jong Doo
中科院分区：
文献类型：
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作者：
Lee, Jeong Won;Kang, Chang Moo;Lee, Jong Doo
在本研究中，我们旨在评估F-18-FDG PET/CT测量的代谢肿瘤体积（MTV）和病灶总糖酵解（TLG）在接受有治愈目的的胰腺癌切除术患者中的预后价值。方法：回顾性分析87例经F-18-FDG PET/CT及手术切除的胰管腺癌患者，其中30例接受新辅助治疗，57例未接受新辅助治疗。在F-18-FDG PET/CT上测量所有患者的最大标准化摄取值（SUVmax）、MTV和TLG。通过单因素和多因素分析评估PET/CT参数和肿瘤因素对无复发生存期（RFS）和总生存期（OS）的预后意义。结果：87例患者中，57例（64%）在随访期间复发。单因素分析显示，肿瘤大小、病理T （pT）分期、SUVmax、MN、TLG是RFS和OS的重要预后因素（P < 0.05），淋巴结转移仅对RFS有预测意义（P < 0.05）。在多因素分析中，肿瘤大小、MTV和TLG是RFS的独立预后因素，pT分期、MW和TLG是OS的独立预后因素。对于未接受新辅助治疗的57例患者，MTV和TLG以及肿瘤大小和SUVmax仍然是肿瘤复发的重要预测因素。结论：MN和TLG是预测胰腺癌患者RFS和OS的独立预后因素。因此，无论是否接受新辅助治疗，F-18-FDG PET/CT都可以为有治愈意图的胰腺癌切除术患者提供有用的预后信息。
In this study, we aimed to assess the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured on F-18-FDG PET/CT in pancreatic cancer patients who underwent resection with curative intent. Methods: Eighty-seven patients with pancreatic ductal adenocarcinoma who underwent F-18-FDG PET/CT and subsequent surgical resection with curative intent with (30 patients) or without (57 patients) neoadjuvant therapy were retrospectively enrolled. The maximum standardized uptake value (SUVmax), MTV, and TLG were measured on F-18-FDG PET/CT in all patients. The prognostic significances of PET/CT parameters and tumor factors for recurrence-free survival (RFS) and overall survival (OS) were evaluated by univariate and multivariate analyses. Results: Of the 87 patients, 57 (64%) experienced recurrence during the follow-up period. The tumor size, pathologic T (pT) stage, SUVmax, MN, and TLG were significant prognostic factors for both RFS and OS (P < 0.05) on univariate analyses, and the presence of lymph node metastasis showed significance only for predicting RFS (P < 0.05). On multivariate analyses, the tumor size, MTV, and TLG were independent prognostic factors for RFS, and pT stage, MW, and TLG were independent prognostic factors for OS. For the 57 patients who did not undergo neoadjuvant treatment, MTV and TLG remained significant predictive factors for tumor recurrence, along with tumor size and SUVmax. Conclusion: MN and TLG are independent prognostic factors for predicting RFS and OS in patients with pancreatic cancer. Thus, F-18-FDG PET/CT can provide useful prognostic information for patients undergoing resection of pancreatic cancer with curative intent irrespective of neoadjuvant treatment.