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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2018 | Original Article

Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer

Authors: Bang-Bin Chen, Yu-Wen Tien, Ming-Chu Chang, Mei-Fang Cheng, Yu-Ting Chang, Shih-Hung Yang, Chih-Horng Wu, Ting-Chun Kuo, I-Lun Shih, Ruoh-Fang Yen, Tiffany Ting-Fang Shih

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2018

Abstract

Purpose

To correlate the overall survival (OS) with the imaging biomarkers of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy, and glucose metabolic activity derived from integrated fluorine 18 fluorodeoxyglucose positron emission tomography (¹⁸F–FDG PET)/MRI in patients with pancreatic cancer.

Methods

This prospective study was approved by the institutional review board and informed consent was obtained from all participants. Sixty-three consecutive patients (mean age, 62.7 ± 12 y; men/women, 40/23) with pancreatic cancer underwent PET/MRI before treatment. The imaging biomarkers were comprised of DCE-MRI parameters (peak, IAUC₆₀, K^trans, k_ep, v_e), the minimum apparent diffusion coefficient (ADC_min), choline level, standardized uptake values, metabolic tumor volume, and total lesion glycolysis (TLG) of the tumors. The relationships between these imaging biomarkers with OS were evaluated with the Kaplan-Meier and Cox proportional hazard models.

Results

Seventeen (27%) patients received curative surgery, with the median follow-up duration being 638 days. Univariate analysis showed that patients at a low TNM stage (≦3, P = 0.041), high peak (P = 0.006), high ADC_min (P = 0.002) and low TLG (P = 0.01) had better OS. Moreover, high TLG/peak ratio was associated with poor OS (P = 0.016). Multivariate analysis indicated that ADC_min (P = 0.011) and TLG/peak ratio (P = 0.006) were independent predictors of OS after adjustment for age, gender, tumor size, and TNM stage. The TLG/peak ratio was an independent predictor of OS in a subgroup of patients who did not receive curative surgery (P = 0.013).

Conclusion

The flow-metabolism mismatch reflected by the TLG/peak ratio may better predict OS than other imaging biomarkers from PET/MRI in pancreatic cancer patients.

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Title: Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer
Authors: Bang-Bin Chen
Yu-Wen Tien
Ming-Chu Chang
Mei-Fang Cheng
Yu-Ting Chang
Shih-Hung Yang
Chih-Horng Wu
Ting-Chun Kuo
I-Lun Shih
Ruoh-Fang Yen
Tiffany Ting-Fang Shih
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-3960-0

At a glance: The STEP trials

Springer Medicine

Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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