Prognostic value of 18FDG PET-CT volumetric parameters in the survival prediction of patients with pancreatic cancer

Halloran, CM ORCID: 0000-0002-5471-4178 (2020) Prognostic value of 18FDG PET-CT volumetric parameters in the survival prediction of patients with pancreatic cancer. Annals of Surgical Oncology, 46 (8). pp. 1532-1538.

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Official URL: http://dx.doi.org/10.1016/j.ejso.2020.02.002

Abstract

<h4>Purpose</h4>To investigate the value of <sup>18</sup> FDG PET/CT volumetric parameters in the prediction of overall survival (OS) in patients with pancreatic cancer and also, assess their independence relative to well-established clinico-pathological variables.<h4>Methods</h4>We conducted a retrospective analysis of patients with a confirmed diagnosis of pancreatic cancer who underwent <sup>18</sup> FDG PET/CT. The tumour maximum standardised uptake value (SUV<sub>max</sub>) in addition to SUV<sub>mean</sub>, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated. The prognostic value of <sup>18</sup> FDG PET/CT and clinico-pathological parameters for OS were assessed using univariate and multivariable analyses.<h4>Results</h4>A sum of 89 patients were analysed in this study. Median survival for patients categorised as having high TLG (≥55) and low TLG (<55) was 18 vs 5 months (p < 0.001). Similarly, the respective high vs low SUV<sub>mean</sub>, MTV and SUVmax were 18 vs 6 months (p = 0.001), 16 vs 6 months (p = 0.002) and 18 vs 6 months (p = 0.001). Univariate analysis showed SUV<sub>max,</sub> SUV<sub>mean,</sub> MTV, TLG, tumour size, tumour differentiation and presence of distant metastasis as prognostic factors for OS. On multivariable analysis, TLG (HR 2.0, 95% CI 1.26-3.18, p = 0.004) and the presence of distant metastasis (HR 3.37, 95% CI 1.97-5.77, p < 0.001) emerged as independent prognostic factors. Subgroup analysis identified TLG as the only significant PET metric after adjusting for the presence of distant metastasis.<h4>Conclusions</h4><sup>18</sup> FDG PET/CT is a useful tool in the preoperative evaluation of patients with pancreatic cancer. Tumour TLG offer an independent prognostic value in both potentially operable and metastatic disease settings.

Item Type:	Article
Uncontrolled Keywords:	(18)Fluoro-deoxy glucose positron emission tomography-computed tomography, Pancreatic cancer, Survival, Prognosis
Depositing User:	Symplectic Admin
Date Deposited:	04 Oct 2019 14:09
Last Modified:	19 Jan 2023 00:24
DOI:	10.1016/j.ejso.2020.02.002
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3056897