Volumetric parameters of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography can predict histopathologic treatment response after neoadjuvant chemoradiotherapy in pancreatic adenocarcinoma

Makoto Sakane, Mitsuaki Tatsumi, Masatoshi Hori, Hiromitsu Onishi, Takahiro Tsuboyama, Atsushi Nakamoto, Takashi Ota, Hidetoshi Eguchi, Kenichi Wakasa, Jun Hatazawa, Noriyuki Tomiyama

Research output: Contribution to journalArticle

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Abstract

Purpose The purpose of this study was to investigate the clinical potential of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) to evaluate histopathologic effects of preoperative chemoradiotherapy (CRT) in pancreatic adenocarcinoma, with particular focus on volumetric PET/CT parameters. Material and methods This study included 25 patients with pancreatic adenocarcinoma who underwent radical surgery after gemcitabine- and S-1-based preoperative-CRT. The extent of residual tumor was graded using the Evans grading systems, and patients with more than 50% destruction of tumor cells were defined as responder. Peak SUV corrected for lean body mass (SULpeak), metabolic tumor volume (MTV) with a threshold of SUV = 2.0, total lesion glycolysis (TLG) of pre- and post-CRT, and reduction rates of SULpeak in those parameters were assessed by PET/CT. These parameters were compared using the student's t-test between responder and non-responder. The treatment effect was also assessed by contingency table analysis divided with median value of each parameter using chi-square tests. Results Eight patients (32%) showed histopathologic poor response (Evans grade I), 11 cases (44%) had mild response (Evans grade IIa), and six cases (24%) had moderate response (Evans grade IIb); therefore, six cases (24%) were assigned to responders and others 19 cases (76%) were non-responders. With regards to volumetric PET parameters, post-CRT SULpeak of responders was significantly lower than that of non-responders (p = 0.013). Post-CRT MTV and TLG were negative for all six cases of responders. There were significant differences between responder and non-responder on the contingency table analysis of post-CRT MTV and TLG status (p = 0.014 for both). Conclusions This study demonstrated that the volumetric PET/CT parameters, higher post-treatment SULpeak and positive MTV/TLG could predict the unfavorable histopathological effects of CRT in patients with pancreatic adenocarcinoma.

Original languageEnglish
Pages (from-to)64-69
Number of pages6
JournalEuropean Journal of Radiology
Volume94
DOIs
Publication statusPublished - Sep 1 2017
Externally publishedYes

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Fluorodeoxyglucose F18
Chemoradiotherapy
Adenocarcinoma
Glycolysis
Tumor Burden
Cone-Beam Computed Tomography
gemcitabine
Therapeutics
Residual Neoplasm
Chi-Square Distribution
Positron Emission Tomography Computed Tomography
Students
Neoplasms

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Volumetric parameters of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography can predict histopathologic treatment response after neoadjuvant chemoradiotherapy in pancreatic adenocarcinoma. / Sakane, Makoto; Tatsumi, Mitsuaki; Hori, Masatoshi; Onishi, Hiromitsu; Tsuboyama, Takahiro; Nakamoto, Atsushi; Ota, Takashi; Eguchi, Hidetoshi; Wakasa, Kenichi; Hatazawa, Jun; Tomiyama, Noriyuki.

In: European Journal of Radiology, Vol. 94, 01.09.2017, p. 64-69.

Research output: Contribution to journalArticle

Sakane, Makoto ; Tatsumi, Mitsuaki ; Hori, Masatoshi ; Onishi, Hiromitsu ; Tsuboyama, Takahiro ; Nakamoto, Atsushi ; Ota, Takashi ; Eguchi, Hidetoshi ; Wakasa, Kenichi ; Hatazawa, Jun ; Tomiyama, Noriyuki. / Volumetric parameters of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography can predict histopathologic treatment response after neoadjuvant chemoradiotherapy in pancreatic adenocarcinoma. In: European Journal of Radiology. 2017 ; Vol. 94. pp. 64-69.
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abstract = "Purpose The purpose of this study was to investigate the clinical potential of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) to evaluate histopathologic effects of preoperative chemoradiotherapy (CRT) in pancreatic adenocarcinoma, with particular focus on volumetric PET/CT parameters. Material and methods This study included 25 patients with pancreatic adenocarcinoma who underwent radical surgery after gemcitabine- and S-1-based preoperative-CRT. The extent of residual tumor was graded using the Evans grading systems, and patients with more than 50{\%} destruction of tumor cells were defined as responder. Peak SUV corrected for lean body mass (SULpeak), metabolic tumor volume (MTV) with a threshold of SUV = 2.0, total lesion glycolysis (TLG) of pre- and post-CRT, and reduction rates of SULpeak in those parameters were assessed by PET/CT. These parameters were compared using the student's t-test between responder and non-responder. The treatment effect was also assessed by contingency table analysis divided with median value of each parameter using chi-square tests. Results Eight patients (32{\%}) showed histopathologic poor response (Evans grade I), 11 cases (44{\%}) had mild response (Evans grade IIa), and six cases (24{\%}) had moderate response (Evans grade IIb); therefore, six cases (24{\%}) were assigned to responders and others 19 cases (76{\%}) were non-responders. With regards to volumetric PET parameters, post-CRT SULpeak of responders was significantly lower than that of non-responders (p = 0.013). Post-CRT MTV and TLG were negative for all six cases of responders. There were significant differences between responder and non-responder on the contingency table analysis of post-CRT MTV and TLG status (p = 0.014 for both). Conclusions This study demonstrated that the volumetric PET/CT parameters, higher post-treatment SULpeak and positive MTV/TLG could predict the unfavorable histopathological effects of CRT in patients with pancreatic adenocarcinoma.",
author = "Makoto Sakane and Mitsuaki Tatsumi and Masatoshi Hori and Hiromitsu Onishi and Takahiro Tsuboyama and Atsushi Nakamoto and Takashi Ota and Hidetoshi Eguchi and Kenichi Wakasa and Jun Hatazawa and Noriyuki Tomiyama",
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T1 - Volumetric parameters of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography can predict histopathologic treatment response after neoadjuvant chemoradiotherapy in pancreatic adenocarcinoma

AU - Sakane, Makoto

AU - Tatsumi, Mitsuaki

AU - Hori, Masatoshi

AU - Onishi, Hiromitsu

AU - Tsuboyama, Takahiro

AU - Nakamoto, Atsushi

AU - Ota, Takashi

AU - Eguchi, Hidetoshi

AU - Wakasa, Kenichi

AU - Hatazawa, Jun

AU - Tomiyama, Noriyuki

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Purpose The purpose of this study was to investigate the clinical potential of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) to evaluate histopathologic effects of preoperative chemoradiotherapy (CRT) in pancreatic adenocarcinoma, with particular focus on volumetric PET/CT parameters. Material and methods This study included 25 patients with pancreatic adenocarcinoma who underwent radical surgery after gemcitabine- and S-1-based preoperative-CRT. The extent of residual tumor was graded using the Evans grading systems, and patients with more than 50% destruction of tumor cells were defined as responder. Peak SUV corrected for lean body mass (SULpeak), metabolic tumor volume (MTV) with a threshold of SUV = 2.0, total lesion glycolysis (TLG) of pre- and post-CRT, and reduction rates of SULpeak in those parameters were assessed by PET/CT. These parameters were compared using the student's t-test between responder and non-responder. The treatment effect was also assessed by contingency table analysis divided with median value of each parameter using chi-square tests. Results Eight patients (32%) showed histopathologic poor response (Evans grade I), 11 cases (44%) had mild response (Evans grade IIa), and six cases (24%) had moderate response (Evans grade IIb); therefore, six cases (24%) were assigned to responders and others 19 cases (76%) were non-responders. With regards to volumetric PET parameters, post-CRT SULpeak of responders was significantly lower than that of non-responders (p = 0.013). Post-CRT MTV and TLG were negative for all six cases of responders. There were significant differences between responder and non-responder on the contingency table analysis of post-CRT MTV and TLG status (p = 0.014 for both). Conclusions This study demonstrated that the volumetric PET/CT parameters, higher post-treatment SULpeak and positive MTV/TLG could predict the unfavorable histopathological effects of CRT in patients with pancreatic adenocarcinoma.

AB - Purpose The purpose of this study was to investigate the clinical potential of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) to evaluate histopathologic effects of preoperative chemoradiotherapy (CRT) in pancreatic adenocarcinoma, with particular focus on volumetric PET/CT parameters. Material and methods This study included 25 patients with pancreatic adenocarcinoma who underwent radical surgery after gemcitabine- and S-1-based preoperative-CRT. The extent of residual tumor was graded using the Evans grading systems, and patients with more than 50% destruction of tumor cells were defined as responder. Peak SUV corrected for lean body mass (SULpeak), metabolic tumor volume (MTV) with a threshold of SUV = 2.0, total lesion glycolysis (TLG) of pre- and post-CRT, and reduction rates of SULpeak in those parameters were assessed by PET/CT. These parameters were compared using the student's t-test between responder and non-responder. The treatment effect was also assessed by contingency table analysis divided with median value of each parameter using chi-square tests. Results Eight patients (32%) showed histopathologic poor response (Evans grade I), 11 cases (44%) had mild response (Evans grade IIa), and six cases (24%) had moderate response (Evans grade IIb); therefore, six cases (24%) were assigned to responders and others 19 cases (76%) were non-responders. With regards to volumetric PET parameters, post-CRT SULpeak of responders was significantly lower than that of non-responders (p = 0.013). Post-CRT MTV and TLG were negative for all six cases of responders. There were significant differences between responder and non-responder on the contingency table analysis of post-CRT MTV and TLG status (p = 0.014 for both). Conclusions This study demonstrated that the volumetric PET/CT parameters, higher post-treatment SULpeak and positive MTV/TLG could predict the unfavorable histopathological effects of CRT in patients with pancreatic adenocarcinoma.

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