Pretreatment F-FDG PET/CT in predicting the survival of patients with hepatic neuroendocrine tumors.

OBJECTIVE

To investigate the prognostic value of pretreatment 2-[F]-fluoro-2-deoxy-d-glucose (F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with hepatic neuroendocrine tumors (HNET).

METHODS

In total, 41 patients were included in this study. PET-derived metabolic parameters, including maximum and mean standardized uptake values (SUV and SUV, respectively), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), of the tumors were measured. Meanwhile, clinical data, including tumor pathological findings such as the Ki-67 index were also assessed. Progression-free survival (PFS) and overall survival (OS) were evaluated. Univariate and multivariate analyses were performed to predict the prognostic value of clinical variables and PET-derived metabolic parameters in HNET patients. Correlation between PET-derived metabolic parameters and Ki-67 was estimated.

RESULTS

Univariate analyses revealed that among PET-derived metabolic parameters, SUV, SUV, and TLG were significant prognostic factors for OS (P < .05). Among clinical variables, the Ki-67 index and radical surgical resection were significant factors for both PFS and OS (P < .05). In multivariate analyses, only Ki-67 index was an independent prognostic factor for both PFS and OS (P < .05). Ki-67 index presented correlates with SUV and SUV (R = 0.566, P < .001, R = 0.493, P = .001, respectively).

CONCLUSIONS

In patients with HNET, the Ki-67 index was an independent prognostic factor for both PFS and OS, while SUV, SUV, and TLG measured on pretreatment F-FDG PET/CT scans were prognostic factors for predicting OS. Ki-67 index also presented correlates with SUV and SUV. F-FDG-PET may be useful as quantitative predicting prognostic imaging biomarkers, especially in poorly differentiated HNET.