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Usefulness of 18 F‐FDG‐PET/CT in the diagnosis and prediction of recurrence of pancreatic neuroendocrine neoplasms
Author(s) -
Sato Asahi,
Masui Toshihiko,
Yogo Akitada,
Uchida Yuichiro,
Nakano Kenzo,
Anazawa Takayuki,
Nagai Kazuyuki,
Takaori Kyoichi,
Nakamoto Yuji,
Uemoto Shinji
Publication year - 2020
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.734
Subject(s) - medicine , avidity , neuroendocrine tumors , multivariate analysis , pathological , univariate analysis , demographics , metastasis , oncology , gastroenterology , cancer , antigen , sociology , demography , immunology
Background Although 18 F‐FDG‐PET/CT is a widely used diagnostic tool for several malignancies, its efficacy in diagnosing pancreatic neuroendocrine tumors is reported to be controversial because of the short‐term follow‐up. Methods We retrospectively compared demographics and pathological features between 18 F‐FDG‐positive and ‐negative diseases. Additionally, we evaluated whether the avidity of 18 F‐FDG‐PET/CT affected earlier recurrence after curative treatment of non‐functioning tumors. The median duration of observation was 65.6 months. Results Seventy‐two patients were enrolled. 18 F‐FDG‐positive diseases were pathologically advanced and significantly associated with metastatic behavior. In a multivariate analysis, metastatic behavior and WHO tumor grade was independently associated with 18 F‐FDG accumulation. Only 25% of functional tumors (4/16) and 8% of insulinomas (1/12) were 18 F‐FDG‐positive. In a Kaplan–Meier analysis in patients with non‐functioning tumors (n = 56), 18 F‐FDG‐positivity was significantly correlated with poorer recurrence‐free survival (RFS) but had no correlation with overall survival. In univariate analysis of factors associated with shorter RFS, male gender, prevalence of nodal metastasis, WHO tumor grade ≥G2, or 18 F‐FDG‐positive disease were significantly higher in patients with shorter RFS, whereas only 18 F‐FDG‐positivity was associated with shorter RFS in multivariate analyses. Conclusions The avidity of 18 F‐FDG‐PET/CT was associated with metastatic behavior of pancreatic neuroendocrine tumors and recurrence after treatment of non‐functioning tumors.