Usefulness of 18F‐FDG‐PET/CT in the diagnosis and prediction of recurrence of pancreatic neuroendocrine neoplasms

• Published in: Journal of hepato-biliary-pancreatic sciences 2020-07, Vol.27 (7), p.414-420
• Main Authors: Sato, Asahi, Masui, Toshihiko, Yogo, Akitada, Uchida, Yuichiro, Nakano, Kenzo, Anazawa, Takayuki, Nagai, Kazuyuki, Takaori, Kyoichi, Nakamoto, Yuji, Uemoto, Shinji
• Format: Article
• Language: English
• Subjects: 18F‐FDG‐PET/CT; Metastasis; neuroendocrine tumor; Neuroendocrine tumors; pancreas; Pancreatic cancer
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.734

Background Although 18F‐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 18F‐FDG‐positive and ‐negative diseases. Additionally, we evaluated whether the avidity of 18F‐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. 18F‐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 18F‐FDG accumulation. Only 25% of functional tumors (4/16) and 8% of insulinomas (1/12) were 18F‐FDG‐positive. In a Kaplan–Meier analysis in patients with non‐functioning tumors (n = 56), 18F‐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 18F‐FDG‐positive disease were significantly higher in patients with shorter RFS, whereas only 18F‐FDG‐positivity was associated with shorter RFS in multivariate analyses. Conclusions The avidity of 18F‐FDG‐PET/CT was associated with metastatic behavior of pancreatic neuroendocrine tumors and recurrence after treatment of non‐functioning tumors.