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

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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 pre-therapeutic 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 MTV of the primary tumor as measured by 18F-FDG PET/CT along with the AJCC stage may be a significant independent prognostic factor for overall survival.

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Conflict of interest

Ho Seong Kim, Joon Young Choi, Dong Wook Choi, Ho Yeong Lim, Joo Hee Lee, Sun Pyo Hong, Young Seok Cho, Kyung-Han Lee, and Byung-Tae Kim declare no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Ho Seong Kim, Joon Young Choi, Joo Hee Lee, Sun Pyo Hong, Young Seok Cho, Kyung-Han Lee & Byung-Tae Kim

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Dong Wook Choi

  3. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Ho Yeong Lim

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  1. Ho Seong Kim
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Correspondence to Joon Young Choi.

Additional information

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (grant no. 1120150).

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Kim, H.S., Choi, J.Y., Choi, D.W. et al. Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors. Nucl Med Mol Imaging 48, 180–186 (2014). https://doi.org/10.1007/s13139-013-0262-0

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