title: Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study.
abstract: OBJECTIVE
  To investigate usefulness of multiparametric fully integrated 18-FDG PET/MRI in predicting treatment response after chemotherapy for unresectable advanced gastric cancers (AGCs).
  
  
  METHODS
  Eleven patients with unresectable AGCs underwent multiparametric 18-FDG PET/MRI examinations prior to chemotherapy. Perfusion parameters obtained via dynamic contrast-enhanced MRI, apparent diffusion coefficient values from diffusion-weighted images, and maximum standardized uptake values (SUVmax) from 18-FDG PET were measured. For parameters obtained from 18-FDG PET/MRI data, interobserver agreement was obtained using intraclass correlation coefficients (ICC) and chemotherapy response relationship was evaluated using the Mann-Whitney test and receiver operating characteristic analysis.
  
  
  RESULTS
  After chemotherapy, six patients were classified into the responder group and five patients into the non-responder group. For all parameters, moderate to nearly perfect agreement was achieved (ICC = 0.452-0.911). K (trans) values (P = 0.018) and initial area under the curves (iAUCs) (P = 0.045) of gastric cancers were significantly higher in responder group than in non-responder group. The area under the curve was 0.917 for K (trans) and 0.867 for iAUC. However, SUVmax values were not significantly different between the two groups.
  
  
  CONCLUSIONS
  Multiparametric approach using fully integrated 18-FDG PET/MRI was shown to be feasible for patients with unresectable gastric cancers. In addition, K (trans) and iAUC values can be used as early predictive markers for chemotherapy response.
  
  
  CONCLUSIONS
  • Multiparametric 18-FDG PET/MRI is feasible for patients with unresectable advanced gastric cancer • K (trans) and iAUC were significantly higher in the responder group of patients • K (trans) , iAUC can be utilized as early predictive markers for chemotherapeutic response.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 28, Yeongon-dong, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Hospital, 28, Yeongon-dong, Jongno-gu, Seoul, 110-744, Korea. shkim7071@gmail.com.
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Do-Youn
authors.initials: DY
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, 28, Yeongon-dong, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000494:pharmacology; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Advanced gastric cancer; Dynamic contrast-enhanced MRI; Multiparametric 18F-fluorodexoyglucose PET/MRI; Palliative chemotherapy; Response prediction