Prognostic significance of standardized uptake value on preoperative 18F-FDG PET/CT in patients with ampullary adenocarcinoma

  • Hye Jin Choi
  • Chang Moo Kang
  • Kwanhyeong Jo
  • Woo Jung Lee
  • Jae-Hoon LeeEmail author
  • Young Hoon Ryu
  • Jong Doo Lee
Original Article



The purpose of this study was to investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with ampullary adenocarcinoma (AAC) after curative surgical resection.


Fifty-two patients with AAC who had undergone 18F-FDG PET/CT and subsequent curative resections were retrospectively enrolled. The maximum standardized uptake value (SUVmax) and tumor to background ratio (TBR) were measured on 18F-FDG PET/CT in all patients. The prognostic significances of PET/CT parameters and clinicopathologic factors for recurrence-free survival (RFS) and overall survival (OS) were evaluated by univariate and multivariate analyses.


Of the 52 patients, 19 (36.5 %) experienced tumor recurrence during the follow-up period and 18 (35.8 %) died. The 3-year RFS and OS were 62.3 and 61.5 %, respectively. Preoperative CA19-9 level, tumor differentiation, presence of lymph node metastasis, SUVmax, and TBR were significant prognostic factors for both RFS and OS (p < 0.05) on univariate analyses, and patient age showed significance only for predicting RFS (p < 0.05). On multivariate analyses, SUVmax and TBR were independent prognostic factors for RFS, and tumor differentiation, SUVmax, and TBR were independent prognostic factors for OS.


SUVmax and TBR on preoperative 18F-FDG PET/CT are independent prognostic factors for predicting RFS and OS in patients with AAC; patients with high SUVmax (>4.80) or TBR (>1.75) had poor survival outcomes. The role of and indications for adjuvant therapy after curative resection of AAC are still unclear. 18F-FDG uptake in the primary tumor could provide additive prognostic information for the decision-making process regarding adjuvant therapy.


Ampullary adenocarcinoma Ampulla of Vater Prognosis 18F-Fluorodeoxyglucose Positron emission tomography Standardized uptake value 



This study was supported by a new faculty research seed money grant of Yonsei University College of Medicine for 2014 (2014-32-0026).

Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hye Jin Choi
    • 1
  • Chang Moo Kang
    • 2
  • Kwanhyeong Jo
    • 3
  • Woo Jung Lee
    • 2
  • Jae-Hoon Lee
    • 3
    • 4
    Email author
  • Young Hoon Ryu
    • 4
  • Jong Doo Lee
    • 3
  1. 1.Division of Oncology, Department of Internal MedicineYonsei University College of MedicineSeoulSouth Korea
  2. 2.Division of Hepatobiliary and Pancreas, Department of SurgeryYonsei University College of MedicineSeoulSouth Korea
  3. 3.Department of Nuclear MedicineYonsei University College of MedicineSeoulSouth Korea
  4. 4.Department of Nuclear Medicine, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea

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