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01.06.2014 | Original Article | Ausgabe 6/2014

European Journal of Nuclear Medicine and Molecular Imaging 6/2014

Metabolic tumour burden assessed by 18F-FDG PET/CT associated with serum CA19-9 predicts pancreatic cancer outcome after resection

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging > Ausgabe 6/2014
Autoren:
Hua-Xiang Xu, Tao Chen, Wen-Quan Wang, Chun-Tao Wu, Chen Liu, Jiang Long, Jin Xu, Ying-Jian Zhang, Run-Hao Chen, Liang Liu, Xian-Jun Yu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00259-014-2688-8) contains supplementary material, which is available to authorized users.
Hua-Xiang Xu, Tao Chen, Wen-Quan Wang and Chun-Tao Wu contributed equally to this work.

Abstract

Purpose

Tumour burden is one of the most important prognosticators for pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to investigate the predictive significance of metabolic tumour burden measured by 18F-FDG PET/CT in patients with resectable PDAC.

Methods

Included in the study were 122 PDAC patients who received preoperative 18F-FDG PET/CT examination and radical pancreatectomy. Metabolic tumour burden in terms of metabolic tumour volume (MTV) and total lesion glycolysis (TLG), pathological tumour burden (tumour size), serum tumour burden (baseline serum CA19-9 level), and metabolic activity (maximum standard uptake value, SUVmax) were determined, and compared for their performance in predicting overall survival (OS) and recurrence-free survival (RFS).

Results

MTV and TLG were significantly associated with baseline serum CA19-9 level (P = 0.001 for MTV, P < 0.001 for TLG) and tumour size (P < 0.001 for MTV, P = 0.001 for TLG). Multivariate analysis showed that MTV, TLG and baseline serum CA19-9 level as either categorical or continuous variables, but not tumour size or SUVmax, were independent risk predictors for both OS and RFS. Time-dependent receiving operating characteristics analysis further indicated that better predictive performances for OS and RFS were achieved by MTV and TLG compared to baseline serum CA19-9 level, SUVmax and tumour size (P < 0.001 for all).

Conclusion

MTV and TLG showed strong consistency with baseline serum CA19-9 level in better predicting OS and RFS, and might serve as surrogate markers for prediction of outcome in patients with resectable PDAC.

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