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17.04.2021 | Nuclear Medicine

Preoperative 2-[¹⁸F]FDG PET-CT aids in the prognostic stratification for patients with primary ampullary carcinoma

verfasst von: Pei-Ju Chuang, Hsiu-Po Wang, Yu-Jen Lin, Chieh-Chang Chen, Yu-Wen Tien, Min-Shu Hsieh, Shih-Hung Yang, Ruoh-Fang Yen, Chi-Lun Ko, Yen-Wen Wu, Mei-Fang Cheng

Erschienen in: European Radiology | Ausgabe 10/2021

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Abstract

Objectives

We sought to investigate whether preoperative dual-phase 2-[¹⁸F]FDG PET-CT identify predictors for poor survival in patients with ampullary carcinoma receiving pancreaticoduodenectomy.

Methods

The preoperative PET-CT images of patients with resected ampullary carcinoma from June 2007 to July 2017 were analyzed. Survival curves were analyzed using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazard model was used to identify potential prognostic factors associated with disease-free survival (DFS) and overall survival (OS).

Results

Fifty-four subjects (26 men, 28 women) were enrolled with a median tumor size of 20 mm. All patients were followed for a median period of 36.9 months with 3- and 5-year DFS of 50.3% and 44.2%, and OS of 77.0% and 68.2%, respectively. Parameters associated with DFS in multivariate analysis were lymphovascular invasion (hazard ratio [HR]: 9.45, p < 0.001), involved margin in pathology (HR: 7.67, p < 0.001), and tumor retention index (RI) from the dual-phase PET (HR: 2.41, p = 0.03), whereas involved margin (HR: 13.14, p < 0.001), post-recurrence chemotherapy (HR: 0.10, p < 0.001), and metabolic tumor volume (MTV) (HR: 4.62, p = 0.009) emerged as independent prognostic factors for OS.

Conclusions

Preoperative 2-[¹⁸F]FDG PET-CT offered independent prognostic biomarkers in patients with ampullary carcinoma receiving standard surgical resection.

Key Points

• 2-[ ¹⁸ F]FDG PET-CT offers good survival prediction before operation in primary malignant neoplasms at ampulla of Vater.

• Dual-phase PET scan with bowel distention can better delineate Ampulla of Vater and characterize tumor physiology.

• Preoperative risk stratification might aid in better treatment planning.

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Titel: Preoperative 2-[18F]FDG PET-CT aids in the prognostic stratification for patients with primary ampullary carcinoma
verfasst von: Pei-Ju Chuang
Hsiu-Po Wang
Yu-Jen Lin
Chieh-Chang Chen
Yu-Wen Tien
Min-Shu Hsieh
Shih-Hung Yang
Ruoh-Fang Yen
Chi-Lun Ko
Yen-Wen Wu
Mei-Fang Cheng
Publikationsdatum: 17.04.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-021-07923-9

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Preoperative 2-[¹⁸F]FDG PET-CT aids in the prognostic stratification for patients with primary ampullary carcinoma