World Journal of Surgery

, Volume 37, Issue 1, pp 169–178 | Cite as

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

  • Hirotada Kittaka
  • Hidenori Takahashi
  • Hiroaki Ohigashi
  • Kunihito Gotoh
  • Terumasa Yamada
  • Yasuhiko Tomita
  • Yoshihisa Hasegawa
  • Masahiko Yano
  • Osamu Ishikawa
Article

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

Keywords

Pancreatic Cancer Standard Uptake Value Pathologic Response Regression Index Nonresponder Group 

Notes

Acknowledgments

This study was supported in part by a Grant from the Mitsui Life Welfare Foundation and a grant from the Otsuka Research Fund.

Conflict of interest

There are no commercial interests in the subject of this study.

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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Hirotada Kittaka
    • 1
  • Hidenori Takahashi
    • 1
  • Hiroaki Ohigashi
    • 1
  • Kunihito Gotoh
    • 1
  • Terumasa Yamada
    • 1
  • Yasuhiko Tomita
    • 2
  • Yoshihisa Hasegawa
    • 3
  • Masahiko Yano
    • 1
  • Osamu Ishikawa
    • 1
  1. 1.Department of SurgeryOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  2. 2.Department of Pathology and CytologyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  3. 3.Morinomiya ClinicOsakaJapan

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