title: Metabolic and morphological measurements of subcutaneous and visceral fat and their relationship with disease stage and overall survival in newly diagnosed pancreatic adenocarcinoma : Metabolic and morphological fat measurements in pancreatic adenocarcinoma.
abstract: OBJECTIVE
  The relationship between tumor metabolism and stage, subcutaneous and visceral fat thickness, and their glucose metabolism and overall survival in patients recently diagnosed with pancreatic carcinoma was assessed.
  
  
  METHODS
  Thirty-eight consecutive patients were studied. Subcutaneous fat thickness (SFT), visceral fat thickness (VFT), and their corresponding FDG SUVmean, as well as SUVmean and SUVmax values of the primary tumor (PT) were derived from FDG-PET CT imaging. Results obtained as well as clinical variables obtained, including gender and BMI, were related to patient outcome. Median follow-up was 382 days (range: 36-917 days).
  
  
  RESULTS
  Median age was 66 years (13 women). Mean BMI was 24.6 (SD: 4.5). Lymph node (LN) involvement was diagnosed in 17 patients and 14 patients presented with distant metastases. Mean SUV max and SUVmean values of the PT were 9.0 (SD 5.9) and 4.2 (SD 2.1). Mean values of SFT and VFT were, respectively, 11.9 mm (range 1-31.7 mm) and 11.5 mm (range 0-49.8 mm). The corresponding SUVmean values were 0.4 (range 0-1.0) and 0.6 (range 0.0-1.6). SUVmean values of SFT proved significantly lower in LNpositive versus LNnegative patients (p = 0.021), in patients with and without metastatic disease (p = 0.017) and in stage III+IV patients versus stage I+II patients (p = 0.03). An inverse logarithmic relationship was found between SUVmean values of subcutaneous fat and SUVmean values of the PT (p = 0.02). Only disease stage dichotomized according to stage I+IIA versus stage IIB+III+IV was predictive of overall survival (p = 0.05).
  
  
  CONCLUSIONS
  Glucose metabolism of subcutaneous fat in de novo diagnosed pancreas carcinoma patients presenting with lymph node involvement and metastatic disease is significantly reduced and inversely correlated to the primary tumor metabolism. Of the various fat-related variables studied, none proved significantly related to outcome.
authors.affiliation: Department of Nuclear Medicine, AZ Groeninge, Reepkaai 4, 8500, Kortrijk, Belgium. cvdwiele@hotmail.com.|Department of Nuclear Medicine and Radiology, University Ghent, De Pintelaan 185, 9000, Ghent, Belgium. cvdwiele@hotmail.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Van de Wiele
authors.affiliation: Department of Nuclear Medicine, AZ Groeninge, Reepkaai 4, 8500, Kortrijk, Belgium.
authors.forename: Mathias
authors.initials: M
authors.lastname: Van Vlaenderen
authors.affiliation: Department of Nuclear Medicine and Radiology, University Ghent, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Ludovic
authors.initials: L
authors.lastname: D'Hulst
authors.affiliation: Department of Nuclear Medicine, CH de Mouscron, Avenue de Fécamp 49 B, 7000, Mouscron, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Delcourt
authors.affiliation: Department of Nuclear Medicine, CHwapi, Avenue Delmée 9, 7500, Tournai, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Copin
authors.affiliation: Laboratory of Drug Quality and Registration, University Ghent, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: De Spiegeleer
authors.affiliation: Department of Nuclear Medicine, AZ Groeninge, Reepkaai 4, 8500, Kortrijk, Belgium.|University of Leuven KULAK, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium.
authors.forename: Alex
authors.initials: A
authors.lastname: Maes
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D000230:Adenocarcinoma / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D050151:Subcutaneous Fat / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Disease stage; Fat; Pancreatic adenocarcinoma; Survival