title: Clinically determined type of 18F-fluoro-2-deoxyglucose uptake as an alternative prognostic marker in resectable pancreatic cancer.
abstract: OBJECTIVE
  To investigate the association between clinical PET (positron emission tomography) type and oncologic outcome in resectable pancreatic cancer.
  
  
  METHODS
  Between January 2008 and October 2012, patients who underwent potentially curative resection for resectable pancreatic ductal adenocarcinoma without neoadjuvant treatment were retrospectively investigated. Clinical PET type was defined as follows: pancreatic cancer with similar 18FDG uptake to renal calyx was determined as kidney-type (K-type), and relatively lower 18FDG uptake than that of renal calyx was regarded as Non-K type.
  
  
  RESULTS
  A total of 53 patients were enrolled. After agreement-based reclassification, agreement based K-type (aK-type) was noted in 34 patients (64.2%), and agreement based Non-K type (aNon K-type) was found in 19 patients (35.8%). There was a significant difference between aK-type and aNon K-type pancreatic cancer (tumor size (P = 0.030), adjusted CA 19-9 (P = 0.007), maximum standard uptake value (SUVmax,P<0.001), metabolic tumor volume (MTV2.5, P<0.001), total lesion glycolysis (TLG, P<0.001)). K-type pancreatic cancer (n = 31) showed a significantly shorter disease-free time compared with Non-K type (n = 16) (10.8 vs. 24.1 months, P = 0.013). It was also noted that aK-type showed inferior disease-free survival to that of aNon-K type pancreatic cancer (11.9 vs. 28.6 months, P = 0.012).
  
  
  CONCLUSIONS
  Clinical PET type is a reliable clinical marker to estimate aggressive tumor biology and can be utilized in predicting tumor recurrence and necessity for postoperative chemotherapy.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
authors.forename: Jae Uk
authors.initials: JU
authors.lastname: Chong
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.affiliation: Department of Surgery, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.|Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Mijin
authors.initials: M
authors.lastname: Yun
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.|Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism / Q000493:pharmacokinetics*; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18