Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Eur Radiol. 2021 Feb;31(2):992-1001. doi: 10.1007/s00330-020-07191-z. Epub 2020 Aug 26.
To perform a correlation analysis between histopathology and imaging in patients with previously untreated pancreatic ductal adenocarcinoma (PDAC) and to determine the prognostic values of clinical, histological, and imaging parameters regarding overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS).
This single-centre study prospectively included 61 patients (32 males; median age, 68.0 years [IQR, 63.0-75.0 years]) with histologically confirmed PDAC and following surgical resection who preoperatively underwent F-FDG PET/CT and DW-MRI. On whole lesions, we measured, using a 42% SUV threshold volume of interest (VOI), the following quantitative parameters: mean and maximum standardised uptake values (SUV and SUV), total lesion glycolysis (TLG), metabolic tumour volume (MTV), mean and minimum apparent diffusion coefficient (ADC and ADC), diffusion total volume (DTV), and MTV/ADC ratio. Spearman's correlation analysis was performed to assess relationships between these markers and histopathological findings from surgical specimens (stage; grade; resection quality; and vascular, perineural, and lymphatic invasion). Kaplan-Meier and Cox hazard ratio methods were used to evaluate the impacts of imaging parameters on OS (n = 41), DSS (n = 36), and PFS (n = 41).
Inverse correlations between ADC and SUV (rho = - 0.34; p = 0.0071), and between SUV and ADC (rho = - 0.29; p = 0.026) were identified. ADC was inversely correlated with tumour grade (rho = - 0.40; p = 0.0015). MTV was an independent predictive factor for OS and DSS, while DTV was an independent predictive factor for PFS.
In previously untreated PDAC, ADC and SUV values are correlated. Combining PET-MRI metrics may help predict PDAC grade and patients' survival.
• Minimum apparent diffusion coefficient derived from DW-MRI inversely correlates with tumour grade in pancreatic ductal adenocarcinoma. • In pancreatic ductal adenocarcinoma, metabolic tumour volume has been confirmed as a predictive factor for patients' overall survival and disease-specific survival. • Combining PET and MRI metrics may help predict grade and patients' survival in pancreatic ductal adenocarcinoma.
对未经治疗的胰腺导管腺癌（PDAC）患者的组织病理学和影像学进行相关性分析，并确定临床、组织学和影像学参数在总生存期（OS）、疾病特异性生存期（DSS）和无进展生存期（PFS）方面的预后价值。
本单中心前瞻性研究纳入了 61 例经组织学证实的 PDAC 患者（32 名男性；中位年龄 68.0 岁[IQR，63.0-75.0 岁]），这些患者在接受手术切除前均接受了 F-FDG PET/CT 和 DW-MRI 检查。我们在全病灶层面上使用 42% SUV 阈值体积感兴趣区（VOI）测量以下定量参数：平均和最大标准摄取值（SUV 和 SUV）、总肿瘤糖酵解（TLG）、肿瘤代谢体积（MTV）、平均和最小表观扩散系数（ADC 和 ADC）、扩散总体积（DTV）和 MTV/ADC 比值。采用 Spearman 相关分析评估这些标志物与手术标本（分期；分级；切除质量；血管、神经周围和淋巴侵袭）组织病理学发现之间的关系。Kaplan-Meier 和 Cox 风险比方法用于评估影像学参数对 OS（n=41）、DSS（n=36）和 PFS（n=41）的影响。
发现 ADC 和 SUV 之间呈负相关（rho=-0.34；p=0.0071），SUV 和 ADC 之间也呈负相关（rho=-0.29；p=0.026）。ADC 与肿瘤分级呈负相关（rho=-0.40；p=0.0015）。MTV 是 OS 和 DSS 的独立预测因素，而 DTV 是 PFS 的独立预测因素。
在未经治疗的 PDAC 中，ADC 和 SUV 值呈负相关。结合 PET-MRI 指标可能有助于预测 PDAC 分级和患者的生存。
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