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EJNMMI Research
Published in: EJNMMI Research 1/2021

Open Access 01-12-2021 | Magnetic Resonance Imaging | Original research

[18F]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma

Authors: Felix N. Harder, Friederike Jungmann, Georgios A. Kaissis, Fabian K. Lohöfer, Sebastian Ziegelmayer, Daniel Havel, Michael Quante, Maximillian Reichert, Roland M. Schmid, Ihsan Ekin Demir, Helmut Friess, Moritz Wildgruber, Jens Siveke, Alexander Muckenhuber, Katja Steiger, Wilko Weichert, Isabel Rauscher, Matthias Eiber, Marcus R. Makowski, Rickmer F. Braren

Published in: EJNMMI Research | Issue 1/2021

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Abstract

Purpose

In this prospective exploratory study, we evaluated the feasibility of [18F]fluorodeoxyglucose ([18F]FDG) PET/MRI-based chemotherapy response prediction in pancreatic ductal adenocarcinoma at two weeks upon therapy onset.

Material and methods

In a mixed cohort, seventeen patients treated with chemotherapy in neoadjuvant or palliative intent were enrolled. All patients were imaged by [18F]FDG PET/MRI before and two weeks after onset of chemotherapy. Response per RECIST1.1 was then assessed at 3 months [18F]FDG PET/MRI-derived parameters (MTV50%, TLG50%, MTV2.5, TLG2.5, SUVmax, SUVpeak, ADCmax, ADCmean and ADCmin) were assessed, using multiple t-test, Man–Whitney-U test and Fisher’s exact test for binary features.

Results

At 72 ± 43 days, twelve patients were classified as responders and five patients as non-responders. An increase in ∆MTV50% and ∆ADC (≥ 20% and 15%, respectively) and a decrease in ∆TLG50% (≤ 20%) at 2 weeks after chemotherapy onset enabled prediction of responders and non-responders, respectively. Parameter combinations (∆TLG50% and ∆ADCmax or ∆MTV50% and ∆ADCmax) further improved discrimination.

Conclusion

Multiparametric [18F]FDG PET/MRI-derived parameters, in particular indicators of a change in tumor glycolysis and cellularity, may enable very early chemotherapy response prediction. Further prospective studies in larger patient cohorts are recommended to their clinical impact.
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Metadata
Title
[18F]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma
Authors
Felix N. Harder
Friederike Jungmann
Georgios A. Kaissis
Fabian K. Lohöfer
Sebastian Ziegelmayer
Daniel Havel
Michael Quante
Maximillian Reichert
Roland M. Schmid
Ihsan Ekin Demir
Helmut Friess
Moritz Wildgruber
Jens Siveke
Alexander Muckenhuber
Katja Steiger
Wilko Weichert
Isabel Rauscher
Matthias Eiber
Marcus R. Makowski
Rickmer F. Braren
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2021
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/s13550-021-00808-4

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