Nucl Med Mol Imaging.  2014 Sep;48(3):180-186. 10.1007/s13139-013-0262-0.

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

• Kim HS
• Choi JY
• Choi DW
• Lim HY
• Lee JH
• Hong SP
• Cho YS
• Lee KH
• Kim BT

• KMID: 2313192
• DOI: http://doi.org/10.1007/s13139-013-0262-0

Abstract

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 pretherapeutic 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 MTVof the primary tumor asmeasured by 18F-FDG PET/CTalong with the AJCC stage may be a significant independent prognostic factor for overall survival.

Keyword

18F-FDG PET/CT; Pancreatic neuroendocrine tumor; Metabolic tumor volume; Total lesion glycolysis; Prognosis

MeSH Terms

Classification
Fluorodeoxyglucose F18*
Follow-Up Studies
Glycolysis
Humans
Multivariate Analysis
Neuroectodermal Tumors, Primitive
Neuroendocrine Tumors*
Positron-Emission Tomography and Computed Tomography*
Prognosis
Retrospective Studies
Tumor Burden
Fluorodeoxyglucose F18