Improved Prognostic Value of Standardized Uptake Value Corrected for Blood Glucose Level in Pancreatic Cancer Using F-18 FDG PET

Abstract

The purpose of this study was to determine the effect of blood glucose level correction on pancreatic cancer prognosis predictions after curative resection using F-18 fluorodeoxyglucose positron emission tomography (FDG PET). We enrolled 43 patients with pancreatic cancer who underwent preoperative FDG PET. Patient outcomes were categorized according to cancer recurrence in the clinical period. Maximum standardized uptake values (SUVmax) of tumors were measured using FDG PET, and blood glucose-corrected SUV (SUVgluc) was calculated as SUVmax × blood glucose level/100. Pancreatic cancer recurrence was observed within 9 months in 24 of 43 patients. SUVgluc, but not SUVmax, was significantly higher in the recurrence group than in the nonrecurrence group. Receiver operating characteristic analysis revealed that SUVgluc of 4.8 and SUVmax of 3.0 were the best cutoff values for predicting tumor recurrence. The 9-month recurrence-free survival rates were 72.3% for patients with SUVgluc ≤ 4.8, 23.5% for patients with SUVgluc >4.8, 75.0% for patients with SUVmax ≤ 3.0, and 45.0% for patients with SUVmax >3.0. SUVgluc was determined to be a significant predictive factor for tumor recurrence, along with differentiation, whereas SUVmax was not. SUVgluc on FDG PET aids in better predicting the prognosis of patients with pancreatic cancer after curative resection than does SUVmax without correction.