Skip to main content
Top
Published in: Nuclear Medicine and Molecular Imaging 5/2018

01-10-2018 | Original Article

Inverse Prognostic Relationships of 18F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery

Authors: Hyun Kyung Yi, Yong-Jin Park, Ji Hoon Bae, Jong Kyun Lee, Kwang Hyuk Lee, Seong Ho Choi, Kyung-Han Lee, Byung-Tae Kim, Joon Young Choi

Published in: Nuclear Medicine and Molecular Imaging | Issue 5/2018

Login to get access

Abstract

Purpose

As there were few previous studies with a small number of subjects, the purpose of this was to evaluate the prognostic significance of 18F-FDG PET/CT in patients with distal bile duct cancer undergoing curative surgery.

Methods

The study included 40 patients (M/F = 24:16; age 68.0 ± 8.0 years) who underwent preoperative 18F-FDG PET/CT followed by curative surgical resection. The participant’s age, sex, Eastern Cooperative Oncology Group performance-status score, baseline serum CA 19-9 level, stage, pathologic T and N stages, tumor size, tumor grade, tumor growth pattern, R0 resection, and adjuvant therapy were included as clinicopathological variables for predicting overall survival. The PET variables were maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the tumor. The Kaplan-Meyer method and Cox proportional hazards model were used for the survival analysis.

Results

A total of 15 of 40 patients (37.5%) died during the follow-up period. In univariate analysis, low SUVmax (≤ 2.7, p = 0.0005) and low SUVavg (≤ 2.6, p = 0.0034) were significant predictors of poor overall survival. In multivariate analyses, only low SUVmax (HR = 6.7016, 95% CI 1.9961–22.4993, p = 0.0047) was an independent prognostic factor associated with poor overall survival.

Conclusion

The SUVmax of the primary tumor measured by 18F-FDG PET/CT was an independent significant prognostic factor for overall survival in patients with distal bile duct cancer. However, different results from a previous study warrant further large sample-sized study.
Literature
1.
go back to reference Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part III: liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134–44.CrossRefPubMed Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part III: liver, biliary tract, and pancreas. Gastroenterology. 2009;136:1134–44.CrossRefPubMed
2.
go back to reference Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg. 1996;224:463–75.CrossRefPubMedPubMedCentral Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg. 1996;224:463–75.CrossRefPubMedPubMedCentral
4.
go back to reference Moon CM, Bang S, Chung JB. The role of (18)F-fluorodeoxyglucose positron emission tomography in the diagnosis, staging, and follow-up of cholangiocarcinoma. Surg Oncol. 2011;20:e10–7.CrossRefPubMed Moon CM, Bang S, Chung JB. The role of (18)F-fluorodeoxyglucose positron emission tomography in the diagnosis, staging, and follow-up of cholangiocarcinoma. Surg Oncol. 2011;20:e10–7.CrossRefPubMed
5.
go back to reference Benson AB 3rd, Abrams TA, Ben-Josef E, Bloomston PM, Botha JF, Clary BM, et al. NCCN clinical practice guidelines in oncology: hepatobiliary cancers. J Natl Compr Cancer Netw. 2009;7:350–91.CrossRef Benson AB 3rd, Abrams TA, Ben-Josef E, Bloomston PM, Botha JF, Clary BM, et al. NCCN clinical practice guidelines in oncology: hepatobiliary cancers. J Natl Compr Cancer Netw. 2009;7:350–91.CrossRef
6.
go back to reference Chung YJ, Choi DW, Choi SH, Heo JS, Kim DH. Prognostic factors following surgical resection of distal bile duct cancer. J Korean Surg Soc. 2013;85:212–8.CrossRefPubMedPubMedCentral Chung YJ, Choi DW, Choi SH, Heo JS, Kim DH. Prognostic factors following surgical resection of distal bile duct cancer. J Korean Surg Soc. 2013;85:212–8.CrossRefPubMedPubMedCentral
7.
go back to reference Yoo J, Choi JY, Lee KT, Heo JS, Park SB, Moon SH, et al. Prognostic significance of volume-based metabolic parameters by (18)F-FDG PET/CT in gallbladder carcinoma. Nucl Med Mol Imaging. 2012;46:201–6.CrossRefPubMedPubMedCentral Yoo J, Choi JY, Lee KT, Heo JS, Park SB, Moon SH, et al. Prognostic significance of volume-based metabolic parameters by (18)F-FDG PET/CT in gallbladder carcinoma. Nucl Med Mol Imaging. 2012;46:201–6.CrossRefPubMedPubMedCentral
8.
go back to reference Kim H, Yoo IR, Boo SH, Park HL, O JH, Kim SH. Prognostic value of pre- and post-treatment FDG PET/CT parameters in small cell lung cancer patients. Nucl Med Mol Imaging. 2018;52:31–8.CrossRefPubMed Kim H, Yoo IR, Boo SH, Park HL, O JH, Kim SH. Prognostic value of pre- and post-treatment FDG PET/CT parameters in small cell lung cancer patients. Nucl Med Mol Imaging. 2018;52:31–8.CrossRefPubMed
9.
go back to reference Lee Y, Yoo IR, Boo SH, Kim H, Park HL, Hyun OJ. The role of F-18 FDG PET/CT in intrahepatic cholangiocarcinoma. Nucl Med Mol Imaging. 2017;51:69–78.CrossRef Lee Y, Yoo IR, Boo SH, Kim H, Park HL, Hyun OJ. The role of F-18 FDG PET/CT in intrahepatic cholangiocarcinoma. Nucl Med Mol Imaging. 2017;51:69–78.CrossRef
10.
go back to reference Hwang JP, Lim I, Na II, Cho EH, Kim BI, Choi CW, et al. Prognostic value of SUVmax measured by fluorine-18 fluorodeoxyglucose positron emission tomography with computed tomography in patients with gallbladder cancer. Nucl Med Mol Imaging. 2014;48:114–20.CrossRefPubMed Hwang JP, Lim I, Na II, Cho EH, Kim BI, Choi CW, et al. Prognostic value of SUVmax measured by fluorine-18 fluorodeoxyglucose positron emission tomography with computed tomography in patients with gallbladder cancer. Nucl Med Mol Imaging. 2014;48:114–20.CrossRefPubMed
11.
go back to reference Choi MK, Choi JY, Lee J, Heo JS, Choi SH, Choi DW, et al. Prognostic and predictive value of metabolic tumor volume on 18F-FDG PET/CT in advanced biliary tract cancer treated with gemcitabine/oxaliplatin with or without erlotinib. Med Oncol. 2014;31:23.CrossRefPubMed Choi MK, Choi JY, Lee J, Heo JS, Choi SH, Choi DW, et al. Prognostic and predictive value of metabolic tumor volume on 18F-FDG PET/CT in advanced biliary tract cancer treated with gemcitabine/oxaliplatin with or without erlotinib. Med Oncol. 2014;31:23.CrossRefPubMed
12.
go back to reference Lee JY, Kim HJ, Yim SH, Shin DS, Yu JH, Ju DY, et al. Primary tumor maximum standardized uptake value measured on 18F-fluorodeoxyglucose positron emission tomography-computed tomography is a prognostic value for survival in bile duct and gallbladder cancer. Korean J Gastroenterol. 2013;62:227–33.CrossRef Lee JY, Kim HJ, Yim SH, Shin DS, Yu JH, Ju DY, et al. Primary tumor maximum standardized uptake value measured on 18F-fluorodeoxyglucose positron emission tomography-computed tomography is a prognostic value for survival in bile duct and gallbladder cancer. Korean J Gastroenterol. 2013;62:227–33.CrossRef
13.
go back to reference Park M-S, Lee S-M. Preoperative 18F-FDG PET-CT maximum standardized uptake value predicts recurrence of biliary tract cancer. Anticancer Res. 2014;34:2551–4.PubMed Park M-S, Lee S-M. Preoperative 18F-FDG PET-CT maximum standardized uptake value predicts recurrence of biliary tract cancer. Anticancer Res. 2014;34:2551–4.PubMed
14.
go back to reference Song JY, Lee YN, Kim YS, Kim SG, Jin SJ, Park JM, et al. Predictability of preoperative 18F-FDG PET for histopathological differentiation and early recurrence of primary malignant intrahepatic tumors. Nucl Med Commun. 2015;36:319–27.CrossRef Song JY, Lee YN, Kim YS, Kim SG, Jin SJ, Park JM, et al. Predictability of preoperative 18F-FDG PET for histopathological differentiation and early recurrence of primary malignant intrahepatic tumors. Nucl Med Commun. 2015;36:319–27.CrossRef
15.
go back to reference Lee SJ, Choi JY, Lee HJ, Baek CH, Son YI, Hyun SH, et al. Prognostic value of volume-based 18F-fluorodeoxyglucose PET/CT parameters in patients with clinically node-negative oral tongue squamous cell carcinoma. Korean J Radiol. 2012;13(6):752–9.CrossRefPubMedPubMedCentral Lee SJ, Choi JY, Lee HJ, Baek CH, Son YI, Hyun SH, et al. Prognostic value of volume-based 18F-fluorodeoxyglucose PET/CT parameters in patients with clinically node-negative oral tongue squamous cell carcinoma. Korean J Radiol. 2012;13(6):752–9.CrossRefPubMedPubMedCentral
16.
go back to reference Cho KM, Oh DY, Kim TY, Lee KH, Han SW, Im SA, et al. Metabolic characteristics of advanced biliary tract cancer using 18F-fluorodeoxyglucose positron emission tomography and their clinical implications. Oncologist. 2015;20:926–33.CrossRefPubMedPubMedCentral Cho KM, Oh DY, Kim TY, Lee KH, Han SW, Im SA, et al. Metabolic characteristics of advanced biliary tract cancer using 18F-fluorodeoxyglucose positron emission tomography and their clinical implications. Oncologist. 2015;20:926–33.CrossRefPubMedPubMedCentral
17.
go back to reference Lee EJ, Chang S-H, Lee TY, Yoon SY, Cheon YK, Shim CS, et al. Prognostic value of FDG-PET/CT total lesion glycolysis for patients with resectable distal bile duct adenocarcinoma. Anticancer Res. 2015;35:6985–91.PubMed Lee EJ, Chang S-H, Lee TY, Yoon SY, Cheon YK, Shim CS, et al. Prognostic value of FDG-PET/CT total lesion glycolysis for patients with resectable distal bile duct adenocarcinoma. Anticancer Res. 2015;35:6985–91.PubMed
18.
go back to reference Hwang S, Lee YJ, Song GW, Park KM, Kim KH, Ahn CS, et al. Prognostic impact of tumor growth type on 7th AJCC staging system for intrahepatic cholangiocarcinoma: a single-center experience of 659 cases. J Gastrointest Surg. 2015;19:1291–304.CrossRefPubMed Hwang S, Lee YJ, Song GW, Park KM, Kim KH, Ahn CS, et al. Prognostic impact of tumor growth type on 7th AJCC staging system for intrahepatic cholangiocarcinoma: a single-center experience of 659 cases. J Gastrointest Surg. 2015;19:1291–304.CrossRefPubMed
19.
go back to reference Jarnagin WR, Bowne W, Klimstra DS, Ben-Porat L, Roggin K, Cymes K, et al. Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma. Ann Surg. 2005;241:703–14.CrossRefPubMedPubMedCentral Jarnagin WR, Bowne W, Klimstra DS, Ben-Porat L, Roggin K, Cymes K, et al. Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma. Ann Surg. 2005;241:703–14.CrossRefPubMedPubMedCentral
20.
go back to reference Cho JY, Han HS, Yoon YS, Hwang DW, Jung K, Kim JH, et al. Preoperative cholangitis and metastatic lymph node have a negative impact on survival after resection of extrahepatic bile duct cancer. World J Surg. 2012;36:1842–7.CrossRefPubMed Cho JY, Han HS, Yoon YS, Hwang DW, Jung K, Kim JH, et al. Preoperative cholangitis and metastatic lymph node have a negative impact on survival after resection of extrahepatic bile duct cancer. World J Surg. 2012;36:1842–7.CrossRefPubMed
21.
go back to reference Akita M, Ajiki T, Matsumoto T, Shinozaki K, Goto T, Asari S, et al. Preoperative cholangitis affects survival outcome in patients with extrahepatic bile duct cancer. J Gastrointest Surg. 2017;21:983–9.CrossRefPubMed Akita M, Ajiki T, Matsumoto T, Shinozaki K, Goto T, Asari S, et al. Preoperative cholangitis affects survival outcome in patients with extrahepatic bile duct cancer. J Gastrointest Surg. 2017;21:983–9.CrossRefPubMed
Metadata
Title
Inverse Prognostic Relationships of 18F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery
Authors
Hyun Kyung Yi
Yong-Jin Park
Ji Hoon Bae
Jong Kyun Lee
Kwang Hyuk Lee
Seong Ho Choi
Kyung-Han Lee
Byung-Tae Kim
Joon Young Choi
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 5/2018
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-018-0542-9

Other articles of this Issue 5/2018

Nuclear Medicine and Molecular Imaging 5/2018 Go to the issue