Multiparametric PET/MR imaging biomarkers are associated with overall survival in patients with pancreatic cancer
Journal
European Journal of Nuclear Medicine and Molecular Imaging
Journal Volume
45
Journal Issue
7
Pages
1205-1217
Date Issued
2018
Abstract
Purpose: To correlate the overall survival (OS) with the imaging biomarkers of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy, and glucose metabolic activity derived from integrated fluorine 18 fluorodeoxyglucose positron emission tomography (18F–FDG PET)/MRI in patients with pancreatic cancer. Methods: This prospective study was approved by the institutional review board and informed consent was obtained from all participants. Sixty-three consecutive patients (mean age, 62.7 ± 12 y; men/women, 40/23) with pancreatic cancer underwent PET/MRI before treatment. The imaging biomarkers were comprised of DCE-MRI parameters (peak, IAUC60, Ktrans, kep, ve), the minimum apparent diffusion coefficient (ADCmin), choline level, standardized uptake values, metabolic tumor volume, and total lesion glycolysis (TLG) of the tumors. The relationships between these imaging biomarkers with OS were evaluated with the Kaplan-Meier and Cox proportional hazard models. Results: Seventeen (27%) patients received curative surgery, with the median follow-up duration being 638?days. Univariate analysis showed that patients at a low TNM stage (≦3, P = 0.041), high peak (P = 0.006), high ADCmin (P = 0.002) and low TLG (P = 0.01) had better OS. Moreover, high TLG/peak ratio was associated with poor OS (P = 0.016). Multivariate analysis indicated that ADCmin (P = 0.011) and TLG/peak ratio (P = 0.006) were independent predictors of OS after adjustment for age, gender, tumor size, and TNM stage. The TLG/peak ratio was an independent predictor of OS in a subgroup of patients who did not receive curative surgery (P = 0.013). Conclusion: The flow-metabolism mismatch reflected by the TLG/peak ratio may better predict OS than other imaging biomarkers from PET/MRI in pancreatic cancer patients. ? 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Other Subjects
antineoplastic agent; biological marker; carcinoembryonic antigen; choline; fluorodeoxyglucose f 18; gadobutrol; biological marker; radiopharmaceutical agent; adjuvant chemotherapy; adjuvant therapy; adult; aged; apparent diffusion coefficient; Article; bypass surgery; cancer patient; cancer size; cancer surgery; cancer survival; cohort analysis; diffusion weighted imaging; disease specific survival; distal pancreatectomy; dynamic contrast-enhanced magnetic resonance imaging; female; follow up; glycolysis; human; laparotomy; magnetic resonance cholangiopancreatography; major clinical study; male; median survival time; multiparametric magnetic resonance imaging; nuclear magnetic resonance spectroscopy; overall survival; pancreas adenocarcinoma; pancreatectomy; pancreaticoduodenectomy; positron emission tomography; whole body MRI; whole body PET; clinical trial; diagnostic imaging; middle aged; mortality; nuclear magnetic resonance imaging; pancreas tumor; prognosis; prospective study; retrospective study; tumor volume; Aged; Biomarkers; Female; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pancreatic Neoplasms; Positron-Emission Tomography; Prognosis; Prospective Studies; Radiopharmaceuticals; Retrospective Studies; Tumor Burden
Publisher
Springer Berlin Heidelberg
Type
journal article