18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma

Ariake, Kyohei; Motoi, Fuyuhiko; Sasaki, Hideo; Mizuma, Masamichi; Maeda, Chiaki Terao; Terao, Chiaki; Tatewaki, Yasuko; Ohtsuka, Hideo; Fukase, Koji; Masuda, Koichi; Hayashi, Hiroki; Takadate, Tatsuyuki; Naitoh, Takeshi; Taki, Yasuyuki; Unno, Michiaki

doi:10.1007/s11605-017-3627-3

Cited by 23 publications

(16 citation statements)

References 24 publications

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“…Our results confirm previous evidence [ 22 , 23 , 37 , 38 , 39 , 40 , 41 , 42 ] of SUVmax (measured in terms of the tumor’s uptake of 18-FDG) being a simple and reliable pretreatment prognostic parameter, as in other malignancies. A summary of the results of other studies on SUVmax as a prognostic factor in cases of resectable pancreatic cancer is given in Table 4 .…”

Section: Discussionsupporting

confidence: 91%

“…Including ours, seven studies have been published [ 22 , 23 , 38 , 39 , 40 , 41 ], all retrospective, concerning a total of 658 patients. SUVmax cut-offs vary greatly, but all the studies report a significantly longer DFS for patients with a low SUVmax, and 4 studies also describe a significantly better OS [ 23 , 38 , 40 , 41 ]. Since SUVmax only gives an indication of peak metabolic activity, not of tumor burden, some authors have explored the value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) as predictors of pancreatic cancer outcome [ 40 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer

Sperti

Friziero

Serafini

et al. 2020

JCM

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There are currently no known preoperative factors for determining the prognosis in pancreatic cancer. The aim of this study was to examine the role of 18-fluorodeoxyglucose (18-FDG) positron emission tomography/computed tomography (18-FDG-PET/CT) as a prognostic factor for patients with resectable pancreatic cancer. Data were obtained from a retrospective analysis of patients who had a preoperative PET scan and then underwent pancreatic resection from January 2007 to December 2015. The maximum standardized uptake value (SUVmax) of 18-FDG-PET/CT was calculated. Patients were divided into high (>3.65) and low (≤3.65) SUVmax groups, and compared in terms of their TNM classification (Union for International Cancer Contro classification), pathological grade, surgical treatment, state of resection margins, lymph node involvement, age, sex, diabetes and serum Carbohydrate Antigen 19-9 (CA 19-9) levels. The study involved 144 patients, 82 with high SUVmax pancreatic cancer and 62 with low SUVmax disease. The two groups’ disease-free and overall survival rates were significantly influenced by tumor stage, lymph node involvement, pathological grade, resection margins and SUVmax. Patients with an SUVmax ≤ 3.65 had a significantly better survival than those with SUVmax > 3.65 (p < 0.001). The same variables were independent predictors of survival on multivariate analysis. The SUVmax calculated with 18-FDG-PET/CT is an important prognostic factor for patients with pancreatic cancer, and may be useful in decisions concerning patients’ therapeutic management.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer

Sperti

Friziero

Serafini

et al. 2020

JCM

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“…After removal of 690 duplicates, a further 2588 articles were excluded after title and abstract screening because they did not meet the prespecified inclusion criteria. The full texts of the remaining 468 studies were evaluated in more detail, and 89 studies were found to meet the eligibility criteria for this systematic review. Among them, 22 studies containing information on clinical factors relevant to recurrence sites were selected for the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The Cochrane Collaboration tool for assessing risk of bias showed that one study had no domain with a high risk of bias and three studies had one of seven domains with a high risk of bias ( Table S3 , supporting information). The overall risk of bias in non‐randomized studies, according to ROBINS‐I, was moderate in 48 studies and serious in 37 studies ( Table S4 , supporting information).…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Tanaka

Mihaljevic

Probst

et al. 2019

British Journal of Surgery

137

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Background: Initial recurrence mapping of resected pancreatic ductal adenocarcinoma (PDAC) could help in stratifying patient subpopulations for optimal postoperative follow-up. The aim of this systematic review and meta-analysis was to investigate the initial recurrence patterns of PDAC and to correlate them with clinicopathological factors.Methods: MEDLINE and Web of Science databases were searched systematically for studies reporting first recurrence patterns after PDAC resection. Data were extracted from the studies selected for inclusion. Pooled odds ratios (ORs) and 95 per cent confidence intervals were calculated to determine the clinicopathological factors related to the recurrence sites. The weighted average of median overall survival was calculated.Results: Eighty-nine studies with 17 313 patients undergoing PDAC resection were included. The weighted median rates of initial recurrence were 20⋅8 per cent for locoregional sites, 26⋅5 per cent for liver, 11⋅4 per cent for lung and 13⋅5 per cent for peritoneal dissemination. The weighted median overall survival times were 19⋅8 months for locoregional recurrence, 15⋅0 months for liver recurrence, 30⋅4 months for lung recurrence and 14⋅1 months for peritoneal dissemination. Meta-analysis revealed that R1 (direct) resection (OR 2⋅21, 95 per cent c.i. 1⋅12 to 4⋅35), perineural invasion (OR 5⋅19, 2⋅79 to 9⋅64) and positive peritoneal lavage cytology (OR 5⋅29, 3⋅03 to 9⋅25) were significantly associated with peritoneal dissemination as initial recurrence site. Low grade of tumour differentiation was significantly associated with liver recurrence (OR 4⋅15, 1⋅71 to 10⋅07).

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“…Therefore, identifying particular tumor characteristics associated with poor prognosis is important at the initial assessment. Numerous 18F-fluorodeoxyglucose (FDG)-PET reports have demonstrated the efficacy of conventional PET features such as maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for predicting therapeutic response and prognosis [6][7][8][9] . However, those conventional PET features do not represent the spatial tumoral heterogeneity, which is deeply associated with cellular and molecular characteristics such as cellular proliferation and necrosis 10,11 .…”

mentioning

confidence: 99%

Prognostic value of FDG-PET radiomics with machine learning in pancreatic cancer

Toyama

Hotta

Motoi

et al. 2020

Sci Rep

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Patients with pancreatic cancer have a poor prognosis, therefore identifying particular tumor characteristics associated with prognosis is important. This study aims to investigate the utility of radiomics with machine learning using 18F-fluorodeoxyglucose (FDG)-PET in patients with pancreatic cancer. We enrolled 161 patients with pancreatic cancer underwent pretreatment FDG-PET/CT. The area of the primary tumor was semi-automatically contoured with a threshold of 40% of the maximum standardized uptake value, and 42 PET features were extracted. To identify relevant PET parameters for predicting 1-year survival, Gini index was measured using random forest (RF) classifier. Twenty-three patients were censored within 1 year of follow-up, and the remaining 138 patients were used for the analysis. Among the PET parameters, 10 features showed statistical significance for predicting overall survival. Multivariate analysis using Cox HR regression revealed gray-level zone length matrix (GLZLM) gray-level non-uniformity (GLNU) as the only PET parameter showing statistical significance. In RF model, GLZLM GLNU was the most relevant factor for predicting 1-year survival, followed by total lesion glycolysis (TLG). The combination of GLZLM GLNU and TLG stratified patients into three groups according to risk of poor prognosis. Radiomics with machine learning using FDG-PET in patients with pancreatic cancer provided useful prognostic information.

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18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma

Cited by 23 publications

References 24 publications

Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer

Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer

Meta-analysis of recurrence pattern after resection for pancreatic cancer

Prognostic value of FDG-PET radiomics with machine learning in pancreatic cancer

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