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Mich, Marlies; Lehner, Sebastian; Paprottka, Philipp M.; Ilhan, Harun; Bartenstein, Peter; Heinemann, Volker; Boeck, Stefan; Albert, Nathalie L.; Fendler, Wolfgang P. (2016): Use of PERCIST for Prediction of Progression-Free and Overall Survival After Radioembolization for Liver Metastases from Pancreatic Cancer. In: Journal of Nuclear Medicine, Vol. 57, No. 3: pp. 355-360
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Abstract

We evaluated the prognostic accuracy of established PET response criteria in patients with liver metastases from pancreatic cancer after treatment with Y-90 microspheres. Methods: Seventeen patients underwent F-18-FDG PET/CT before and 3 mo after radioembolization for liver metastases from pancreatic cancer. Overall survival, progression-free survival, and time to intrahepatic progression were among other factors correlated with metabolic response as revealed by PERCIST 1.0 defined declining SUVpeak and total-lesion glycolysis. Results: Metabolic response by change in SUVpeak (7/17) and change in total-lesion glycolysis (7/17) was a predictor for overall survival (P = 0.039;hazard ratio [HR], 0.24;95% confidence interval [CI], 0.06-0.93), progression-free survival (P = 0.016;HR, 0.15;95% CI, 0.03-0.69), and time to intrahepatic progression (P = 0.010;HR, 0.16;95% CI, 0.04-0.65). A summed baseline CT diameter of less than 8 cm for the 2 largest liver metastases predicted time to intrahepatic progression (P = 0.013;HR, 0.21;95% CI, 0.06-0.72) but did not predict overall or progression-free survival. Patient outcome was not predicted by other parameters, including baseline SUVpeak, baseline total-lesion glycolysis, or change in serum level of carcinoembryonic antigen or carbohydrate antigen 19-9 from baseline to follow-up (each, P > 0.05). Conclusion: Metabolic response by F-18-FDG PET/CT predicts overall survival, progression-free survival, and time to intrahepatic progression after radioembolization for liver metastases from pancreatic cancer.