Prognostic Value of FDG PET/CT–Derived Parameters in Pancreatic Adenocarcinoma at Initial PET/CT Staging
| Autor: | Richard L. Wahl, Timothy M. Pawlik, Krishna Alluri, Joseph M. Herman, Alin Chirindel, Muhammad A. Chaudhry, Rathan M. Subramaniam |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Standardized uptake value Adenocarcinoma Multimodal Imaging Lesion Fluorodeoxyglucose F18 Pancreatic tumor medicine Humans Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Retrospective Studies Aged 80 and over PET-CT Proportional hazards model business.industry Retrospective cohort study General Medicine Metabolic tumor volume Middle Aged Prognosis medicine.disease Tumor Burden Pancreatic Neoplasms Survival Rate Positron-Emission Tomography Radiographic Image Interpretation Computer-Assisted Female Radiology Radiopharmaceuticals medicine.symptom Tomography X-Ray Computed Nuclear medicine business |
| Zdroj: | American Journal of Roentgenology. 204:1093-1099 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | The purpose of this study is to evaluate the performance of PET-derived parameters as prognostic markers for overall survival (OS) and progression-free survival (PFS) outcome in patients with pancreatic adenocarcinoma.We conducted a retrospective study of 106 patients (62 men and 44 women) with histologically proven pancreatic adenocarcinoma who underwent initial staging FDG PET/CT before treatment. Peak standardized uptake value (SUV), maximum SUV (SUVmax), metabolic tumor volume, and tumor glycolytic activity of the primary pancreatic tumor were measured. Two segmentation methods were performed to obtain the metabolic tumor volume and tumor glycolytic activity for all tumors: a gradient-based segmentation model (metabolic tumor volume and tumor glycolytic activity by gradient edge detection) and a fixed-threshold model with a threshold of 50% of the lesion's SUVmax and peak SUV. Univariate and multivariate Cox regression models were developed including clinical and imaging parameters for OS and PFS.Multivariate Cox regression analysis showed a statistically significant association between PFS and age, SUVmax, peak SUV, and tumor glycolytic activity by gradient edge detection. There was a statistically significant difference in PFS for patients with values above and below the median cutoff points for SUVmax (hazard ratio [HR], 1.12; p0.01), peak SUV (HR, 1.25; p0.02), and tumor glycolytic activity measured by gradient edge detection (HR, 1.00; p0.02) of the primary tumor. However, multivariate Cox regression analysis showed a statistically significant association only between tumor glycolytic activity by gradient edge detection and OS (p = 0.04), and there was a statistically significant difference in OS between patients with values above and below the median cutoff point for the tumor glycolytic activity by gradient edge detection of the primary tumor (HR, 1.42; p = 0.05).Age, SUVmax, peak SUV, and total lesion glycolysis (i.e., tumor glycolytic activity) of the primary tumor are associated with PFS, and tumor glycolytic activity is associated with OS in patients with pancreatic adenocarcinoma. |
| Databáze: | OpenAIRE |
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