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. 2016 Mar;41(3):177-81.
doi: 10.1097/RLU.0000000000001098.

Metabolic Activity by 18F-FDG-PET/CT Is Prognostic for Stage I and II Pancreatic Cancer

Jose M Pimiento  1 , Ashley H Davis-Yadley, Richard D Kim, Dung-Tsa Chen, Edward A Eikman, Claudia G Berman, Mokenge P Malafa
Affiliations

Metabolic Activity by 18F-FDG-PET/CT Is Prognostic for Stage I and II Pancreatic Cancer

Jose M Pimiento et al. Clin Nucl Med. 2016 Mar.

Abstract

Purpose: Metabolic activity, as defined by F-FDG uptake on PET, is a prognostic marker for multiple malignancies; however, no study has examined the prognostic value of imaging with FDG PET in stage I and II pancreatic cancer. We examined the value of PET FDG uptake in early-stage pancreatic cancer patients.

Methods: We identified patients with early-stage pancreatic cancer (I-II) who had FDG PET scan performed as part of their preoperative evaluation. The patients were divided into either high or low FDG uptake according to the median primary tumor standard uptake value (SUVmax). Our primary end points were overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier estimate was used for survival analysis. Pathologic data were compared using the Fisher exact and χ tests.

Results: One hundred five patients were identified: 51 patients with low FDG uptake and 54 patients with high FDG uptake. Eighty-five patients (81%) had PET avid tumors, whereas 20 (19%) patients did not. High FDG uptake correlated with pathologic stage (P = 0.012). Patients with low FDG uptake had significantly better median OS than patients with high FDG uptake (28 vs. 16 months; P = 0.036). Patients with low-FDG uptake had significantly longer median RFS than patients with high FDG uptake (14 vs. 12 months; P = 0.049).

Conclusions: Low FDG uptake in PET scans in patients with stage I and II pancreatic cancer correlates with improved OS and RFS. This supports the concept that glucose metabolic pathways are important in pancreatic cancer biology and that PET scan activity can be used as a prognostic biomarker after pancreatectomy.

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Conflict of interest statement

Conflict of Interest: All authors declare no conflict of interest.

Figures

Figure 1
Figure 1. FDG Uptake
Low vs. high FDG uptake is displayed in the following CT and PET scans.
Figure 2
Figure 2. Overall survival
Patients with low-FDG uptake had significantly better median overall survival than patients with high-FDG uptake.
Figure 3
Figure 3. Recurrence-free survival
Patients with low-FDG uptake had significantly longer median recurrence-free survival than patients with high-FDG uptake.
See this image and copyright information in PMC

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