Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative ¹⁸F-FDG PET/CT in Patients with Pancreatic Cancer.
In this study, we aimed to assess the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured on (18)F-FDG PET/CT in pancreatic cancer patients who underwent resection with curative intent.


METHODS
Eighty-seven patients with pancreatic ductal adenocarcinoma who underwent (18)F-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 (18)F-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, MTV, 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, MTV, 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.


CONCLUSIONS
MTV and TLG are independent prognostic factors for predicting RFS and OS in patients with pancreatic cancer. Thus, (18)F-FDG PET/CT can provide useful prognostic information for patients undergoing resection of pancreatic cancer with curative intent irrespective of neoadjuvant treatment.
Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jeong Won
JW
Lee
Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Chang Moo
CM
Kang
Division of Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; and.
Hye Jin
HJ
Choi
Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Woo Jung
WJ
Lee
Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Si Young
SY
Song
Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea docnuke@yuhs.ac.
Jae-Hoon
JH
Lee
Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jong Doo
JD
Lee
D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
D019788:Fluorodeoxyglucose F18
18F-FDG; PET; metabolic tumor volume; pancreatic cancer; prognosis