[F-18]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma

Harder, Felix N.; Jungmann, Friederike; Kaissis, Georgios A.; Lohoefer, Fabian K.; Ziegelmayer, Sebastian; Havel, Daniel; Quante, Michael; Reichert, Maximillian; Schmid, Roland M.; Demir, Ihsan Ekin; Friess, Helmut; Wildgruber, Moritz; Siveke, Jens; Muckenhuber, Alexander; Steiger, Katja; Weichert, Wilko; Rauscher, Isabel; Eiber, Matthias; Makowski, Marcus R. und Braren, Rickmer F. (2021): [F-18]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma. In: EJNMMI Research, Bd. 11, Nr. 1, 70

Abstract

Purpose In this prospective exploratory study, we evaluated the feasibility of [F-18]fluorodeoxyglucose ([F-18]FDG) PET/MRI-based chemotherapy response prediction in pancreatic ductal adenocarcinoma at two weeks upon therapy onset. Material and methods In a mixed cohort, seventeen patients treated with chemotherapy in neoadjuvant or palliative intent were enrolled. All patients were imaged by [F-18]FDG PET/MRI before and two weeks after onset of chemotherapy. Response per RECIST1.1 was then assessed at 3 months [F-18]FDG PET/MRI-derived parameters (MTV50%, TLG(50%), MTV2.5, TLG(2.5), SUVmax, SUVpeak, ADC(max), ADC(mean) and ADC(min)) were assessed, using multiple t-test, Man-Whitney-U test and Fisher's exact test for binary features. Results At 72 +/- 43 days, twelve patients were classified as responders and five patients as non-responders. An increase in increment MTV50% and increment ADC (>= 20% and 15%, respectively) and a decrease in increment TLG(50%) (<= 20%) at 2 weeks after chemotherapy onset enabled prediction of responders and non-responders, respectively. Parameter combinations ( increment TLG(50%) and increment ADC(max) or increment MTV50% and increment ADC(max)) further improved discrimination. Conclusion Multiparametric [F-18]FDG PET/MRI-derived parameters, in particular indicators of a change in tumor glycolysis and cellularity, may enable very early chemotherapy response prediction. Further prospective studies in larger patient cohorts are recommended to their clinical impact.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2191-219X
• Sprache: Englisch