Department of General Surgery, Royal Brisbane and Women's Hospital, Australia; Faculty of Medicine, University of Queensland, Australia.
Faculty of Medicine, University of Queensland, Australia; Department of Nuclear Medicine, Royal Brisbane and Women's Hospital, Australia.
HPB (Oxford). 2022 Aug;24(8):1387-1393. doi: 10.1016/j.hpb.2022.01.005. Epub 2022 Jan 30.
SUVmax of a primary pancreatic tumour on FDG-PET/CT (SUVmax-p) may predict early post-operative recurrence. This has not been tested in the context of routine pre-operative FDG-PET/CT. It is also unknown whether this association exists independent of local residual tumour.
FDG-PET/CT was performed routinely prior to resection of pancreatic or peri-ampullary adenocarcinoma between 2008 and 2012 as part of a previous prospective study. We compared SUVmax-p according to whether recurrence was diagnosed within 6 months of resection. We also determined the odds ratio for recurrence within 6 months for multiple cut-points of SUVmax-p. This analysis was repeated exclusively for patients who had resection with clear surgical margins (R0).
Of 56 patients from the initial study 23 underwent resection and were eligible. Recurrence within 6 months was associated with higher median SUVmax-p (5.9 vs 3.5; p = 0.04). This was also observed in 12 patients who underwent R0 resection (6.5 vs 2.2; p = 0.05). The cut-point with the highest odds for recurrence within 6 months for both groups was SUVmax-p ≥ 5.5 (OR = 10.8, CI = 1.56-109; OR[R0] = 24.0, CI = 1.64-1020).
SUVmax-p on routine FDG-PET/CT is useful for identifying patients likely to benefit from additional pre-operative staging or neoadjuvant therapy, even where clear margins can confidently be achieved.
在 FDG-PET/CT 上原发性胰腺肿瘤的 SUVmax（SUVmax-p）可能预测术后早期复发。这尚未在常规术前 FDG-PET/CT 中进行测试。也不知道这种关联是否独立于局部残留肿瘤存在。
在 2008 年至 2012 年期间，作为先前前瞻性研究的一部分，对胰腺或壶腹周围腺癌切除术进行了常规 FDG-PET/CT。我们根据术后 6 个月内是否诊断出复发来比较 SUVmax-p。我们还确定了 SUVmax-p 的多个截断值在 6 个月内复发的几率比。此分析仅针对具有明确手术切缘（R0）的患者重复进行。
在最初的研究中，有 56 名患者中有 23 名接受了手术并符合条件。6 个月内复发与更高的 SUVmax-p 中位数相关（5.9 比 3.5；p=0.04）。在接受 R0 切除的 12 名患者中也观察到了这种情况（6.5 比 2.2；p=0.05）。对于两组患者，复发几率最高的 SUVmax-p 截断值均为 SUVmax-p≥5.5（OR=10.8，CI=1.56-109；OR[R0]=24.0，CI=1.64-1020）。
即使可以明确获得清晰的切缘，常规 FDG-PET/CT 上的 SUVmax-p 也可用于识别可能受益于额外术前分期或新辅助治疗的患者。
