Role of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Predicting the Pathologic Response to Preoperative Chemoradiation Therapy in Patients With Resectable T3 Pancreatic Cancer
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- Kittaka, H., Takahashi, H., Ohigashi, H. et al. World J Surg (2013) 37: 169. doi:10.1007/s00268-012-1775-x
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The purpose of this study was to evaluate whether 18F-fluorodeoxyglucose positron emission tomography in combination with computed tomography (FDG-PET/CT) could correctly predict the pathologic response to preoperative chemoradiation therapy (CRT) for resectable pancreatic cancer.
Each of the 40 patients underwent FDG-PET/CT before and after preoperative CRT. The maximum standard uptake value (SUV) was measured for the primary tumor before and after preoperative CRT, defined as pre-CRT SUV and post-CRT SUV, respectively. The proportional alteration of the SUV decline (regression index) between post-CRT SUV and pre-CRT SUV was also calculated. These three indicators were associated with the pathologic response.
Patients were classified as 21 responders and 19 nonresponders according to the histologic features. A pre-CRT SUV ≥4.7 was seen in 15 (71 %) of 21 responders and in 6 (32 %) of 19 nonresponders (p = 0.03). A regression index ≥0.46 was seen in 15 (71 %) responders and 5 (26 %) nonresponders (p = 0.01).
A better pathological response can be expected for pancreatic cancer patients who have a high regression index (≥0.46) and a high pre-CRT SUV (≥4.7). The SUV measurement using FDG-PET/CT is a useful tool for predicting the pathologic response to preoperative CRT.