Prognostic Value of the Metabolic Response on Serial 18F-FDG PET/CT in Pancreatic Cancer.

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Gut and Liver Pub Date : 2025-05-15 Epub Date: 2025-03-07 DOI:10.5009/gnl240458
Jinwoo Ahn, Yoo Sung Song, Bomi Kim, Soomin Yang, Kwangrok Jung, Jong-Chan Lee, Jaihwan Kim, Jin-Hyeok Hwang
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Abstract

Background/aims: The prognostic value of serial 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) for patients with borderline resectable or locally advanced pancreatic cancer who undergo conversion surgery or continue chemotherapy without surgery has not been well-established.

Methods: A retrospective analysis of patients with pancreatic ductal adenocarcinoma was conducted at Seoul National University Bundang Hospital between March 2013 and February 2022. Patients underwent PET/CT at baseline and subsequent radiologic evaluations following chemotherapy. Changes in the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis were analyzed. Based on their treatment regimens, patients were stratified into the conversion surgery group or nonconversion surgery group. Survival outcomes and various clinical factors were assessed.

Results: Among 121 patients, 52 underwent conversion surgery, and 69 continued to receive chemotherapy without surgery. A significant reduction in the SUVmax was correlated with prolonged recurrence-free survival and overall survival in the conversion surgery group. Confirmation of a pathologic response indicated a significant association between reductions in the SUVmax and positive outcomes. Reductions in the metabolic tumor volume and total lesion glycolysis were associated with improved progression-free survival and overall survival in the nonconversion surgery group.

Conclusions: Serial PET/CT scans demonstrated prognostic value in pancreatic ductal adenocarcinoma patients, revealing distinct correlations in the conversion surgery group and nonconversion surgery group.

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18F-FDG系列PET/CT对胰腺癌代谢反应的预后价值
背景/目的:系列18f -氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT)对行转换手术或继续化疗而不手术的边缘可切除或局部晚期胰腺癌患者的预后价值尚未确定。方法:回顾性分析2013年3月至2022年2月在首尔国立大学盆唐医院就诊的胰腺导管腺癌患者。患者在基线时接受PET/CT检查,化疗后进行放射学评估。分析最大标准化摄取值(SUVmax)、平均标准化摄取值(SUVmean)、代谢肿瘤体积和病变糖酵解总量的变化。根据治疗方案将患者分为转换手术组和非转换手术组。评估生存结果和各种临床因素。结果:121例患者中,52例进行了转换手术,69例继续接受化疗。在转换手术组中,SUVmax的显著降低与延长无复发生存期和总生存期相关。病理反应的证实表明SUVmax的减少与阳性结果之间存在显著关联。在非转换手术组中,代谢性肿瘤体积和病变总糖酵解的减少与无进展生存期和总生存期的改善相关。结论:连续PET/CT扫描对胰腺导管腺癌患者的预后具有一定的预测价值,在转换手术组和非转换手术组显示出明显的相关性。
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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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