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Surgery Today

, Volume 49, Issue 1, pp 21–26 | Cite as

Clinical role of fludeoxyglucose (18F) positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with pancreatic neuroendocrine tumors

  • Takashi Matsumoto
  • Hirohisa OkabeEmail author
  • Yo-ichi Yamashita
  • Toshihiko Yusa
  • Rumi Itoyama
  • Yosuke Nakao
  • Takanobu Yamao
  • Naoki Umzaki
  • Masayo Tsukamoto
  • Yuki Kitano
  • Tatsunori Miyata
  • Kota Arima
  • Hidetoshi Nitta
  • Hiromitsu Hayashi
  • Katsunori Imai
  • Akira Chikamoto
  • Hideo Baba
Original Article

Abstract

Purposes

Clinical predictive markers for the malignant potential of pancreatic neuroendocrine tumors (PNETs) are limited without histological investigation. We reported previously that a loss of the regular enhancement pattern in preoperative computed tomography (CT) was correlated with the malignant tumor phenotype. This study aimed to establish whether the metabolic aspect of the tumor evaluated by fludeoxyglucose (18F) positron emission tomography/computed tomography 18F-FDG PET/CT is associated with the tumor imaging characteristics and postoperative oncological outcome.

Methods

Among 77 patients who underwent surgery with curative intent for a PNET at our institution between 2001 and 2017, 24 who received 18F-FDG PET/CT before surgery were enrolled in this study. The clinical importance of the standardized uptake value (SUVmax) was investigated with regard to tumor progression and prognosis after curative surgery.

Results

There were four (16%) patients with insulinoma. The mean tumor size was 17 mm and when the median value of the SUVmax (= 2.0) was measured as the cut-off value, the SUVmax ≥ 2.0 group (n = 12) was associated with large tumor size (p = 0.021), high tumor grade (p = 0.015), and irregular pattern on CT (p = 0.0055). The SUVmax was not correlated with age, gender, whether the tumor was functioning or non-functioning, or lymph node metastasis. The SUVmax ≥ 2.0 group had significantly poorer disease-free survival (median, 3.5 vs 16.2 months; p = 0.023) and poorer overall survival (median, 8.8 vs 16.2 months; p = 0.042).

Conclusion

An SUVmax ≥ 2.0 on 18F-FDG PET/CT might be associated with higher malignant potential of PNETs.

Keywords

Pancreatic neuroendocrine tumor 18F-FDG PET/CT Irregular shape and enhancement pattern 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

Takashi Matsumoto and his co-authors have no conflicts of interest.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Takashi Matsumoto
    • 1
  • Hirohisa Okabe
    • 1
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  • Yo-ichi Yamashita
    • 1
  • Toshihiko Yusa
    • 1
  • Rumi Itoyama
    • 1
  • Yosuke Nakao
    • 1
  • Takanobu Yamao
    • 1
  • Naoki Umzaki
    • 1
  • Masayo Tsukamoto
    • 1
  • Yuki Kitano
    • 1
  • Tatsunori Miyata
    • 1
  • Kota Arima
    • 1
  • Hidetoshi Nitta
    • 1
  • Hiromitsu Hayashi
    • 1
  • Katsunori Imai
    • 1
  • Akira Chikamoto
    • 1
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Life SciencesKumamoto UniversityKumamotoJapan

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