التفاصيل البيبلوغرافية
| العنوان: |
Baseline Characteristics and Use of Pretherapeutic 18F-Fluorodeoxyglucose-PET for Pancreatic Cancer. |
| المؤلفون: |
Carlson, Danielle M.1, Abdelrahman, Amro M.2, Adjei Antwi, Stella K.2, Tomlinson, Jennifer L.2, Trivedi, Kamaxi3, Karbhari, Aashna3, Patnam Gopal Chetty, Nandakumar3, Halfdanarson, Thor R.4, Goenka, Ajit H.5, Truty, Mark J.2 truty.mark@mayo.edu |
| المصدر: |
Journal of the American College of Surgeons (2563-9021). Jul2024, Vol. 239 Issue 1, p9-17. 9p. |
| مصطلحات موضوعية: |
*CONTINUING education units, *ADENOCARCINOMA, *BIOPSY, *PEARSON correlation (Statistics), *RADIOPHARMACEUTICALS, *T-test (Statistics), *DEOXY sugars, *LOGISTIC regression analysis, *POSITRON emission tomography computed tomography, *TREATMENT effectiveness, *RETROSPECTIVE studies, *MAGNETIC resonance imaging, *POSITRON emission tomography, *DESCRIPTIVE statistics, *MANN Whitney U Test, *CHI-squared test, *PANCREATIC tumors, *LONGITUDINAL method, *ODDS ratio, *DUCTAL carcinoma, *COMBINED modality therapy, *STATISTICS, *TUMOR antigens, *CANCER patient psychology, *COMPARATIVE studies, *DATA analysis software, *CONFIDENCE intervals, *BIOMARKERS |
| مستخلص: |
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive and lethal malignancy. Surgical resection is the only curative modality combined with neoadjuvant chemotherapy to improve survival. Given the limitations of traditional responses such as cross-sectional imaging (CT/MRI) or tumor markers, carbohydrate antigen 19-9 (CA19-9), the 2023 National Comprehensive Cancer Network guidelines included 18F-fluorodeoxyglucose (FDG)-PET as an adjunct to assess response to neoadjuvant chemotherapy. There are common misconceptions on the metabolic activity (tumor avidity) in PDAC so we aimed to describe the baseline characteristics and use of FDG-PET in a cohort of treatment-naive patients with PDAC. STUDY DESIGN: A single-center retrospective study was conducted capturing all biopsy-proven, treatmentnaive patients with PDAC who underwent either baseline FDG-PET/CT or FDG-PET/MRI imaging between 2008 and 2023. Baseline FDG-PET characteristics were collected, including primary tumors' maximum standardized uptake value defined as metabolic activity (FDG uptake) of tumor compared with surrounding pancreatic parenchymal background, and the identification of extrapancreatic metastatic disease. RESULTS: We identified 1,095 treatment-naive patients with PDAC who underwent baseline FDG-PET imaging at diagnosis. CA19-9 was elevated in 76% of patients. Overall, 96.3% (1,054) of patients had FDG-avid tumors with a median maximum standardized uptake value of 6.4. FDG-PET also identified suspicious extrapancreatic metastatic lesions in 50% of patients, with a higher proportion (p < 0.001) in PET/MRI (59.9%) vs PET/CT (44.3%). After controlling for CA19-9 elevation, PET/MRI was superior in detection of extrapancreatic lesions compared with PET/CT. CONCLUSIONS: FDG-PET has significant use in PDAC as a baseline imaging modality earlier neoadjuvant therapy given the majority of tumors are FDG-avid. FDG-PET can identify additional extrapancreatic suspicious lesions allowing for optimal initial staging, with PET/MRI having increased sensitivity over PET/CT. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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