title: Role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in predicting the pathologic response to preoperative chemoradiation therapy in patients with resectable T3 pancreatic cancer.
abstract: BACKGROUND
  The purpose of this study was to evaluate whether (18)F-fluorodeoxyglucose positron emission tomography in combination with computed tomography (FDG-PET/CT) could correctly predict the pathologic response to preoperative chemoradiation therapy (CRT) for resectable pancreatic cancer.
  
  
  METHODS
  Each of the 40 patients underwent FDG-PET/CT before and after preoperative CRT. The maximum standard uptake value (SUV) was measured for the primary tumor before and after preoperative CRT, defined as pre-CRT SUV and post-CRT SUV, respectively. The proportional alteration of the SUV decline (regression index) between post-CRT SUV and pre-CRT SUV was also calculated. These three indicators were associated with the pathologic response.
  
  
  RESULTS
  Patients were classified as 21 responders and 19 nonresponders according to the histologic features. A pre-CRT SUV ≥ 4.7 was seen in 15 (71 %) of 21 responders and in 6 (32 %) of 19 nonresponders (p = 0.03). A regression index ≥ 0.46 was seen in 15 (71 %) responders and 5 (26 %) nonresponders (p = 0.01).
  
  
  CONCLUSIONS
  A better pathological response can be expected for pancreatic cancer patients who have a high regression index (≥ 0.46) and a high pre-CRT SUV (≥ 4.7). The SUV measurement using FDG-PET/CT is a useful tool for predicting the pathologic response to preoperative CRT.
authors.affiliation: Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. kitukitu4310@yahoo.co.jp
authors.forename: Hirotada
authors.initials: H
authors.lastname: Kittaka
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohigashi
authors.forename: Kunihito
authors.initials: K
authors.lastname: Gotoh
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18