Abstract
Background: The maximum standardised uptake value (SUVmax) represent the metabolic activity in a single voxel of the tumour and might not be representative of the overall local tumour burden. We aimed to assess the value of 18 FDG PET-CT volumetric parameters in the survival prediction of patients with pancreatic cancer and also, assess their independence relative to well-established clinicopathological variables. Material & Methods: We conducted a retrospective analysis of patients with a confirmed diagnosis of pancreatic cancer who underwent 18 FDG PET-CT at our institution in the period between January 2011 and April 2013. The tumour maximum standardised uptake value (SUVmax) in addition to SUVmean, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were calculated. Survival at various time points was conducted based on high and low 18 FDG PET-CT parameters dichotomised around their respective median values using the Kaplan Meier method and comparison was made using the log rank test. The prognostic value of 18 FDG-PET/CT and clinicopathological parameters for OS were assessed by univariate and multivariate analyses. Results: A sum of 89 patients were analysed in this study. The median survival for patients with respective high and low: SUVmax (18 vs 6 months, p =0.0005), SUVmean (18 vs 6 months, p=0.007), MTV (16 vs 6 months, p= 0.0011) and TLG (18 vs 5 months, p=0.001). Univariate analysis showed SUVmax, SUVmean, MTV, TLG, tumour size, tumour differentiation and presence of distant metastasis as prognostic factors for OS. On multivariate analysis, SUVmax (HR 1.07; 95% 1.01-1.12, p=0.013) and presence of distant metastasis (HR 3.39; 95% CI 1.99-5.81, p<0.001) emerged as independent prognostic factors. Conclusions: Tumour’s SUVmax on 18 FDG PET-CT holds an independent prognostic value in patients with pancreatic cancer. The prognostic role of 18 FDG PET-CT volumetric parameters will require further review in future studies.
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