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KMID : 1148920140480030180
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Nuclear Medicine and Molecular Imaging
2014 Volume.48 No. 3 p.180 ~ p.186
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Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors
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Kim Ho-Seong
Choi Joon-Young
Choi Dong-Wook
Lim Ho-Yeong
Lee Joo-Hee
Hong Sun-Pyo
Cho Young-Seok
Lee Kyung-Han
Kim Byung-Tae
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Abstract
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Purpose: To date, the prognostic value of 18F-FDG PET/CT for patients with pancreatic neuroendocrine tumors (PNETs) has not been well characterized. We investigated the prognostic value of volumetric parameters using 18F-FDG PET/CT in this patient population.
Methods: We retrospectively reviewed 20 cases of pathologically proven PNET in patients who had undergone pre-therapeutic 18F-FDG PET/CT. PET parameters including maximum and average standardized uptake values (SUVmax, SUVave), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were measured using a threshold SUV to determine the boundaries of the tumors. Univariate and multivariate survival analyses were performed with adjustments for PET parameters and other clinical values.
Results: The median clinical follow-up was 22.3 (range, 1.2?95.4) months. Cancer-related death occurred in 5 of 20 patients (25 %). Patients had clinical or pathological stages of I in seven patients, II in six patients, III in three patient, and IV in four patients. According to the WHO histological classification of subtypes, 3 patients exhibited well-differentiated PNETs, 13 patients had well-differentiated endocrine carcinomas, and 4 had poorly differentiatedendocrine carcinomas. Univariate analysis showed that tumor size (p?=?0.028), AJCC stage (p?=?0.009), T stage (p?=?0.028), M stage (p?=?0.029), treatment modality (p?=?0.045), MTV (p?=?0.003) and TLG (p?=?0.027) were significant predictors of overall survival. On multivariate analysis, MTV (HR?=?10.859, p?=?0.031) was a significant independent predictor of overall survival along with the AJCC stage (HR?=?11.556, p?=?0.027).
Conclusion: In patients with PNETs, the MTV of the primary tumor as measured by 18F-FDG PET/CT along with the AJCC stage may be a significant independent prognostic factor for overall survival.
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KEYWORD
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18F-FDG PET/CT, Pancreatic neuroendocrine tumor, Metabolic tumor volume, Total lesion glycolysis, Prognosis
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