Clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in predicting World Health Organization grade in pancreatic neuroendocrine tumors

Yoshito Tomimaru, Hidetoshi Eguchi, Mitsuaki Tatsumi, Tonsok Kim, Naoki Hama, Hiroshi Wada, Koichi Kawamoto, Shogo Kobayashi, Eiichi Morii, Masaki Mori, Yuichiro Doki, Hiroaki Nagano

Research output: Contribution to journalArticle

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Abstract

Background Pancreatic neuroendocrine tumors (PNETs) present various histologic stages, and their clinical behavior ranges from benign to highly aggressive. World Health Organization (WHO) grading categorizes PNETs into 3 groups (G1, G2, and G3) based on proliferative activity. The aim of this study was to assess the clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in preoperative differential diagnosis for various histologic grades of PNETs and in predicting postoperative prognosis in PNET patients. Methods We investigated prospectively 36 patients who underwent preoperative FDG-PET, received surgery for PNETs, and had resected specimens examined via histology. The maximum standardized uptake value (SUVmax) was determined on FDG-PET, and differentiating power between G1/G2 and G3 PNETs was examined using various SUVmax cutoff levels. We also evaluated the prognostic impact of FDG-PET findings using postoperative survival data. Results SUVmax significantly correlated with WHO grade (Spearman rank correlation 0.584; P =.0018), and the SUVmax of G3 tumors (5.0 ± 2.5; n = 4) was significantly higher than that of G1/G2 tumors (2.7 ± 1.6; n = 32; P =.0159). Using 2.5 as a cutoff SUVmax, the sensitivity, specificity, and accuracy of differentiating G3 tumors from G1/G2 tumors were 100.0%, 62.5%, and 66.7%, respectively. Furthermore, the SUVmax of FDG-PET (<2.5 vs ≥2.5) was significantly related to postoperative disease-free survival (P =.0463). Conclusion These results suggest that FDG-PET may be useful for differentiating G3 PNETs from G1/G2 PNETs and for predicting postoperative prognosis in PNET patients. This preliminary finding is expected to be confirmed by prospective validation with more patients.

Original languageEnglish
Pages (from-to)269-276
Number of pages8
JournalSurgery (United States)
Volume157
Issue number2
DOIs
Publication statusPublished - Feb 1 2015

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Neuroendocrine Tumors
Fluorodeoxyglucose F18
Positron-Emission Tomography
Deoxyglucose
Neoplasms
Disease-Free Survival
Histology
Differential Diagnosis
Sensitivity and Specificity
Survival

All Science Journal Classification (ASJC) codes

  • Surgery

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Clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in predicting World Health Organization grade in pancreatic neuroendocrine tumors. / Tomimaru, Yoshito; Eguchi, Hidetoshi; Tatsumi, Mitsuaki; Kim, Tonsok; Hama, Naoki; Wada, Hiroshi; Kawamoto, Koichi; Kobayashi, Shogo; Morii, Eiichi; Mori, Masaki; Doki, Yuichiro; Nagano, Hiroaki.

In: Surgery (United States), Vol. 157, No. 2, 01.02.2015, p. 269-276.

Research output: Contribution to journalArticle

Tomimaru, Y, Eguchi, H, Tatsumi, M, Kim, T, Hama, N, Wada, H, Kawamoto, K, Kobayashi, S, Morii, E, Mori, M, Doki, Y & Nagano, H 2015, 'Clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in predicting World Health Organization grade in pancreatic neuroendocrine tumors', Surgery (United States), vol. 157, no. 2, pp. 269-276. https://doi.org/10.1016/j.surg.2014.09.011
Tomimaru, Yoshito ; Eguchi, Hidetoshi ; Tatsumi, Mitsuaki ; Kim, Tonsok ; Hama, Naoki ; Wada, Hiroshi ; Kawamoto, Koichi ; Kobayashi, Shogo ; Morii, Eiichi ; Mori, Masaki ; Doki, Yuichiro ; Nagano, Hiroaki. / Clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in predicting World Health Organization grade in pancreatic neuroendocrine tumors. In: Surgery (United States). 2015 ; Vol. 157, No. 2. pp. 269-276.
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abstract = "Background Pancreatic neuroendocrine tumors (PNETs) present various histologic stages, and their clinical behavior ranges from benign to highly aggressive. World Health Organization (WHO) grading categorizes PNETs into 3 groups (G1, G2, and G3) based on proliferative activity. The aim of this study was to assess the clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in preoperative differential diagnosis for various histologic grades of PNETs and in predicting postoperative prognosis in PNET patients. Methods We investigated prospectively 36 patients who underwent preoperative FDG-PET, received surgery for PNETs, and had resected specimens examined via histology. The maximum standardized uptake value (SUVmax) was determined on FDG-PET, and differentiating power between G1/G2 and G3 PNETs was examined using various SUVmax cutoff levels. We also evaluated the prognostic impact of FDG-PET findings using postoperative survival data. Results SUVmax significantly correlated with WHO grade (Spearman rank correlation 0.584; P =.0018), and the SUVmax of G3 tumors (5.0 ± 2.5; n = 4) was significantly higher than that of G1/G2 tumors (2.7 ± 1.6; n = 32; P =.0159). Using 2.5 as a cutoff SUVmax, the sensitivity, specificity, and accuracy of differentiating G3 tumors from G1/G2 tumors were 100.0{\%}, 62.5{\%}, and 66.7{\%}, respectively. Furthermore, the SUVmax of FDG-PET (<2.5 vs ≥2.5) was significantly related to postoperative disease-free survival (P =.0463). Conclusion These results suggest that FDG-PET may be useful for differentiating G3 PNETs from G1/G2 PNETs and for predicting postoperative prognosis in PNET patients. This preliminary finding is expected to be confirmed by prospective validation with more patients.",
author = "Yoshito Tomimaru and Hidetoshi Eguchi and Mitsuaki Tatsumi and Tonsok Kim and Naoki Hama and Hiroshi Wada and Koichi Kawamoto and Shogo Kobayashi and Eiichi Morii and Masaki Mori and Yuichiro Doki and Hiroaki Nagano",
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T1 - Clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography in predicting World Health Organization grade in pancreatic neuroendocrine tumors

AU - Tomimaru, Yoshito

AU - Eguchi, Hidetoshi

AU - Tatsumi, Mitsuaki

AU - Kim, Tonsok

AU - Hama, Naoki

AU - Wada, Hiroshi

AU - Kawamoto, Koichi

AU - Kobayashi, Shogo

AU - Morii, Eiichi

AU - Mori, Masaki

AU - Doki, Yuichiro

AU - Nagano, Hiroaki

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Background Pancreatic neuroendocrine tumors (PNETs) present various histologic stages, and their clinical behavior ranges from benign to highly aggressive. World Health Organization (WHO) grading categorizes PNETs into 3 groups (G1, G2, and G3) based on proliferative activity. The aim of this study was to assess the clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in preoperative differential diagnosis for various histologic grades of PNETs and in predicting postoperative prognosis in PNET patients. Methods We investigated prospectively 36 patients who underwent preoperative FDG-PET, received surgery for PNETs, and had resected specimens examined via histology. The maximum standardized uptake value (SUVmax) was determined on FDG-PET, and differentiating power between G1/G2 and G3 PNETs was examined using various SUVmax cutoff levels. We also evaluated the prognostic impact of FDG-PET findings using postoperative survival data. Results SUVmax significantly correlated with WHO grade (Spearman rank correlation 0.584; P =.0018), and the SUVmax of G3 tumors (5.0 ± 2.5; n = 4) was significantly higher than that of G1/G2 tumors (2.7 ± 1.6; n = 32; P =.0159). Using 2.5 as a cutoff SUVmax, the sensitivity, specificity, and accuracy of differentiating G3 tumors from G1/G2 tumors were 100.0%, 62.5%, and 66.7%, respectively. Furthermore, the SUVmax of FDG-PET (<2.5 vs ≥2.5) was significantly related to postoperative disease-free survival (P =.0463). Conclusion These results suggest that FDG-PET may be useful for differentiating G3 PNETs from G1/G2 PNETs and for predicting postoperative prognosis in PNET patients. This preliminary finding is expected to be confirmed by prospective validation with more patients.

AB - Background Pancreatic neuroendocrine tumors (PNETs) present various histologic stages, and their clinical behavior ranges from benign to highly aggressive. World Health Organization (WHO) grading categorizes PNETs into 3 groups (G1, G2, and G3) based on proliferative activity. The aim of this study was to assess the clinical utility of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in preoperative differential diagnosis for various histologic grades of PNETs and in predicting postoperative prognosis in PNET patients. Methods We investigated prospectively 36 patients who underwent preoperative FDG-PET, received surgery for PNETs, and had resected specimens examined via histology. The maximum standardized uptake value (SUVmax) was determined on FDG-PET, and differentiating power between G1/G2 and G3 PNETs was examined using various SUVmax cutoff levels. We also evaluated the prognostic impact of FDG-PET findings using postoperative survival data. Results SUVmax significantly correlated with WHO grade (Spearman rank correlation 0.584; P =.0018), and the SUVmax of G3 tumors (5.0 ± 2.5; n = 4) was significantly higher than that of G1/G2 tumors (2.7 ± 1.6; n = 32; P =.0159). Using 2.5 as a cutoff SUVmax, the sensitivity, specificity, and accuracy of differentiating G3 tumors from G1/G2 tumors were 100.0%, 62.5%, and 66.7%, respectively. Furthermore, the SUVmax of FDG-PET (<2.5 vs ≥2.5) was significantly related to postoperative disease-free survival (P =.0463). Conclusion These results suggest that FDG-PET may be useful for differentiating G3 PNETs from G1/G2 PNETs and for predicting postoperative prognosis in PNET patients. This preliminary finding is expected to be confirmed by prospective validation with more patients.

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