Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer

Massimo Midiri, Domenico Albano, Massimo Galia, Pierpaolo Alongi, Marco Messina, Demetrio Familiari, Roberta Gentile, Maria C. Fornito, Salvatore Scalisi, Massimo Midiri, Massimiliano Spada, Federico Midiri

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Abstract

Aim The aim of this retrospective multicentre study was to evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). Materials and methods Data from patients treated for primary PC, who underwent18F-FDG-PET/CT for suspicious of disease progression, were collected. Accuracy was assessed employing conventional diagnostic procedures, multidisciplinary team case notes, further18F-FDG-PET/CT scans and/or follow-up. Receiver operating characteristic curve and likelihood ratio (LR+/-) analyses were used for completion of accuracy definition. Progression-free survival (PFS) and overall survival were assessed by using Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome. Results Fifty-two patients (33 males and 19 females, with mean age of 59 years and range: 42-78 years) with PC were finally included in our study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of18F-FDG-PET were 85, 84, 90, 76, and 84%, respectively. Area under the curve was 0.84 (95% confidence intervals: 0.72-0.96; P<0.05). LR+ and LR- were 5.3 and 0.17, respectively.18F-FDG-PET/CT revealed new metastatic foci in 5/52 patients (10%) and excluded suspicious lesions in 11/52 (21%). Analysis of PFS revealed18F-FDG-PET/CT positivity to be associated with a worse cumulative survival rate over a 6 and 12-month period in comparison with18F-FDG-PET/CT negativity (6-month PFS 95 vs. 67%, P<0.05; 12-month PFS 81 vs. 29%, P<0.05). A negative18F-FDG-PET/CT result was associated with a significantly longer overall survival than a positive one (70 vs. 26% after 2 years, P<0.05). In addition, a positive18F-FDG-PET/CT scan result and an maximum standardized uptake value (SUVmax) value more than 6 were significantly associated with an increased risk of disease progression (PET positivity hazard ratio=3.9, P=0.01; SUVmax>6 h=4.2, P=0.02) and death (PET positivity hazard ratio=3.5, P=0.02; SUVmax>6 h=3.7, P=0.01). Conclusion18F-FDG-PET/CT showed high diagnostic accuracy for restaging process of PC, proving also its potential value in predicting clinical outcome after primary treatment.
Original languageEnglish
Pages (from-to)741-746
Number of pages6
JournalDefault journal
Volume39
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer. / Midiri, Massimo; Albano, Domenico; Galia, Massimo; Alongi, Pierpaolo; Messina, Marco; Familiari, Demetrio; Gentile, Roberta; Fornito, Maria C.; Scalisi, Salvatore; Midiri, Massimo; Spada, Massimiliano; Midiri, Federico.

In: Default journal, Vol. 39, 2018, p. 741-746.

Research output: Contribution to journalArticle

Midiri, M, Albano, D, Galia, M, Alongi, P, Messina, M, Familiari, D, Gentile, R, Fornito, MC, Scalisi, S, Midiri, M, Spada, M & Midiri, F 2018, 'Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer', Default journal, vol. 39, pp. 741-746.
Midiri, Massimo ; Albano, Domenico ; Galia, Massimo ; Alongi, Pierpaolo ; Messina, Marco ; Familiari, Demetrio ; Gentile, Roberta ; Fornito, Maria C. ; Scalisi, Salvatore ; Midiri, Massimo ; Spada, Massimiliano ; Midiri, Federico. / Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer. In: Default journal. 2018 ; Vol. 39. pp. 741-746.
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title = "Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer",
abstract = "Aim The aim of this retrospective multicentre study was to evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). Materials and methods Data from patients treated for primary PC, who underwent18F-FDG-PET/CT for suspicious of disease progression, were collected. Accuracy was assessed employing conventional diagnostic procedures, multidisciplinary team case notes, further18F-FDG-PET/CT scans and/or follow-up. Receiver operating characteristic curve and likelihood ratio (LR+/-) analyses were used for completion of accuracy definition. Progression-free survival (PFS) and overall survival were assessed by using Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome. Results Fifty-two patients (33 males and 19 females, with mean age of 59 years and range: 42-78 years) with PC were finally included in our study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of18F-FDG-PET were 85, 84, 90, 76, and 84{\%}, respectively. Area under the curve was 0.84 (95{\%} confidence intervals: 0.72-0.96; P<0.05). LR+ and LR- were 5.3 and 0.17, respectively.18F-FDG-PET/CT revealed new metastatic foci in 5/52 patients (10{\%}) and excluded suspicious lesions in 11/52 (21{\%}). Analysis of PFS revealed18F-FDG-PET/CT positivity to be associated with a worse cumulative survival rate over a 6 and 12-month period in comparison with18F-FDG-PET/CT negativity (6-month PFS 95 vs. 67{\%}, P<0.05; 12-month PFS 81 vs. 29{\%}, P<0.05). A negative18F-FDG-PET/CT result was associated with a significantly longer overall survival than a positive one (70 vs. 26{\%} after 2 years, P<0.05). In addition, a positive18F-FDG-PET/CT scan result and an maximum standardized uptake value (SUVmax) value more than 6 were significantly associated with an increased risk of disease progression (PET positivity hazard ratio=3.9, P=0.01; SUVmax>6 h=4.2, P=0.02) and death (PET positivity hazard ratio=3.5, P=0.02; SUVmax>6 h=3.7, P=0.01). Conclusion18F-FDG-PET/CT showed high diagnostic accuracy for restaging process of PC, proving also its potential value in predicting clinical outcome after primary treatment.",
keywords = "18F-FDG-PET/CT; disease progression; overall survival; pancreatic cancer; progression-free survival; restaging; Adult; Aged; Female; Humans; Male; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms; Prognosis; Retrospective Studies; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Radiology, Nuclear Medicine and Imaging",
author = "Massimo Midiri and Domenico Albano and Massimo Galia and Pierpaolo Alongi and Marco Messina and Demetrio Familiari and Roberta Gentile and Fornito, {Maria C.} and Salvatore Scalisi and Massimo Midiri and Massimiliano Spada and Federico Midiri",
year = "2018",
language = "English",
volume = "39",
pages = "741--746",
journal = "Default journal",

}

TY - JOUR

T1 - Clinical and prognostic value of18F-FDG-PET/CT in restaging of pancreatic cancer

AU - Midiri, Massimo

AU - Albano, Domenico

AU - Galia, Massimo

AU - Alongi, Pierpaolo

AU - Messina, Marco

AU - Familiari, Demetrio

AU - Gentile, Roberta

AU - Fornito, Maria C.

AU - Scalisi, Salvatore

AU - Midiri, Massimo

AU - Spada, Massimiliano

AU - Midiri, Federico

PY - 2018

Y1 - 2018

N2 - Aim The aim of this retrospective multicentre study was to evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). Materials and methods Data from patients treated for primary PC, who underwent18F-FDG-PET/CT for suspicious of disease progression, were collected. Accuracy was assessed employing conventional diagnostic procedures, multidisciplinary team case notes, further18F-FDG-PET/CT scans and/or follow-up. Receiver operating characteristic curve and likelihood ratio (LR+/-) analyses were used for completion of accuracy definition. Progression-free survival (PFS) and overall survival were assessed by using Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome. Results Fifty-two patients (33 males and 19 females, with mean age of 59 years and range: 42-78 years) with PC were finally included in our study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of18F-FDG-PET were 85, 84, 90, 76, and 84%, respectively. Area under the curve was 0.84 (95% confidence intervals: 0.72-0.96; P<0.05). LR+ and LR- were 5.3 and 0.17, respectively.18F-FDG-PET/CT revealed new metastatic foci in 5/52 patients (10%) and excluded suspicious lesions in 11/52 (21%). Analysis of PFS revealed18F-FDG-PET/CT positivity to be associated with a worse cumulative survival rate over a 6 and 12-month period in comparison with18F-FDG-PET/CT negativity (6-month PFS 95 vs. 67%, P<0.05; 12-month PFS 81 vs. 29%, P<0.05). A negative18F-FDG-PET/CT result was associated with a significantly longer overall survival than a positive one (70 vs. 26% after 2 years, P<0.05). In addition, a positive18F-FDG-PET/CT scan result and an maximum standardized uptake value (SUVmax) value more than 6 were significantly associated with an increased risk of disease progression (PET positivity hazard ratio=3.9, P=0.01; SUVmax>6 h=4.2, P=0.02) and death (PET positivity hazard ratio=3.5, P=0.02; SUVmax>6 h=3.7, P=0.01). Conclusion18F-FDG-PET/CT showed high diagnostic accuracy for restaging process of PC, proving also its potential value in predicting clinical outcome after primary treatment.

AB - Aim The aim of this retrospective multicentre study was to evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). Materials and methods Data from patients treated for primary PC, who underwent18F-FDG-PET/CT for suspicious of disease progression, were collected. Accuracy was assessed employing conventional diagnostic procedures, multidisciplinary team case notes, further18F-FDG-PET/CT scans and/or follow-up. Receiver operating characteristic curve and likelihood ratio (LR+/-) analyses were used for completion of accuracy definition. Progression-free survival (PFS) and overall survival were assessed by using Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome. Results Fifty-two patients (33 males and 19 females, with mean age of 59 years and range: 42-78 years) with PC were finally included in our study. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of18F-FDG-PET were 85, 84, 90, 76, and 84%, respectively. Area under the curve was 0.84 (95% confidence intervals: 0.72-0.96; P<0.05). LR+ and LR- were 5.3 and 0.17, respectively.18F-FDG-PET/CT revealed new metastatic foci in 5/52 patients (10%) and excluded suspicious lesions in 11/52 (21%). Analysis of PFS revealed18F-FDG-PET/CT positivity to be associated with a worse cumulative survival rate over a 6 and 12-month period in comparison with18F-FDG-PET/CT negativity (6-month PFS 95 vs. 67%, P<0.05; 12-month PFS 81 vs. 29%, P<0.05). A negative18F-FDG-PET/CT result was associated with a significantly longer overall survival than a positive one (70 vs. 26% after 2 years, P<0.05). In addition, a positive18F-FDG-PET/CT scan result and an maximum standardized uptake value (SUVmax) value more than 6 were significantly associated with an increased risk of disease progression (PET positivity hazard ratio=3.9, P=0.01; SUVmax>6 h=4.2, P=0.02) and death (PET positivity hazard ratio=3.5, P=0.02; SUVmax>6 h=3.7, P=0.01). Conclusion18F-FDG-PET/CT showed high diagnostic accuracy for restaging process of PC, proving also its potential value in predicting clinical outcome after primary treatment.

KW - 18F-FDG-PET/CT; disease progression; overall survival; pancreatic cancer; progression-free survival; restaging; Adult; Aged; Female; Humans; Male; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms; Prognosis; Retrospective Studies; Fluorodeoxyglucose F1

KW - Nuclear Medicine and Imaging

UR - http://hdl.handle.net/10447/338427

UR - http://journals.lww.com/nuclearmedicinecomm

M3 - Article

VL - 39

SP - 741

EP - 746

JO - Default journal

JF - Default journal

ER -