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Inverse Prognostic Relationships of 18F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery

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Abstract

Purpose

As there were few previous studies with a small number of subjects, the purpose of this was to evaluate the prognostic significance of 18F-FDG PET/CT in patients with distal bile duct cancer undergoing curative surgery.

Methods

The study included 40 patients (M/F = 24:16; age 68.0 ± 8.0 years) who underwent preoperative 18F-FDG PET/CT followed by curative surgical resection. The participant’s age, sex, Eastern Cooperative Oncology Group performance-status score, baseline serum CA 19-9 level, stage, pathologic T and N stages, tumor size, tumor grade, tumor growth pattern, R0 resection, and adjuvant therapy were included as clinicopathological variables for predicting overall survival. The PET variables were maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the tumor. The Kaplan-Meyer method and Cox proportional hazards model were used for the survival analysis.

Results

A total of 15 of 40 patients (37.5%) died during the follow-up period. In univariate analysis, low SUVmax (≤ 2.7, p = 0.0005) and low SUVavg (≤ 2.6, p = 0.0034) were significant predictors of poor overall survival. In multivariate analyses, only low SUVmax (HR = 6.7016, 95% CI 1.9961–22.4993, p = 0.0047) was an independent prognostic factor associated with poor overall survival.

Conclusion

The SUVmax of the primary tumor measured by 18F-FDG PET/CT was an independent significant prognostic factor for overall survival in patients with distal bile duct cancer. However, different results from a previous study warrant further large sample-sized study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    Hyun Kyung Yi, Yong-Jin Park, Ji Hoon Bae, Kyung-Han Lee, Byung-Tae Kim & Joon Young Choi

  2. Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jong Kyun Lee & Kwang Hyuk Lee

  3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seong Ho Choi

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  1. Hyun Kyung Yi
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Correspondence to Joon Young Choi.

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Conflict of Interest

Hyun Kyung Yi, Yong-Jin Park, Ji Hoon Bae, Jong Kyun Lee, Kwang Hyuk Lee, Seong Ho Choi, Kyung-Han Lee, Byung-Tae Kim, and Joon Young Choi declare that they have no conflicts of interest.

Ethics Statement

All procedures performed in studies that involved human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

For this type of study, formal consent was not required.

Informed Consent

The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived.

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Yi, H.K., Park, YJ., Bae, J.H. et al. Inverse Prognostic Relationships of 18F-FDG PET/CT Metabolic Parameters in Patients with Distal Bile Duct Cancer Undergoing Curative Surgery. Nucl Med Mol Imaging 52, 334–341 (2018). https://doi.org/10.1007/s13139-018-0542-9

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  • DOI: https://doi.org/10.1007/s13139-018-0542-9

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