PET/MRI in pancreatic and periampullary cancer: correlating diffusion-weighted imaging, MR spectroscopy and glucose metabolic activity with clinical stage and prognosis

• Published in: European journal of nuclear medicine and molecular imaging 2016-09, Vol.43 (10), p.1753-1764
• Main Authors: Chen, Bang-Bin, Tien, Yu-Wen, Chang, Ming-Chu, Cheng, Mei-Fang, Chang, Yu-Ting, Wu, Chih-Horng, Chen, Xin-Jia, Kuo, Ting-Chun, Yang, Shih-Hung, Shih, I-Lun, Lai, Hong-Shiee, Shih, Tiffany Ting-Fang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - metabolism; Cancer; Cardiology; Correlation analysis; Diffusion; Diffusion Magnetic Resonance Imaging - methods; Disease-Free Survival; Female; Fluorodeoxyglucose F18 - pharmacokinetics; Glucose; Glucose - metabolism; Humans; Imaging; Magnetic Resonance Spectroscopy - methods; Male; Mass spectrometry; Medical diagnosis; Medicine; Medicine & Public Health; Metabolic Clearance Rate; Metabolic syndrome; Middle Aged; Neoplasm Staging; NMR; Nuclear magnetic resonance; Nuclear Medicine; Oncology; Original Article; Orthopedics; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - metabolism; Positron-Emission Tomography - methods; Prevalence; Prognosis; Radiology; Radiopharmaceuticals - pharmacokinetics; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Taiwan - epidemiology; Young Adult
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-016-3356-y

Purpose To correlate the clinical stage and prognosis of pancreatic or periampullary cancer with the imaging biomarkers on diffusion-weighted imaging, magnetic resonance spectroscopy and glucose metabolic activity derived from integrated PET/MRI. Methods This prospective study was approved by the institutional review board and informed consent was obtained. The study group comprised 60 consecutive patients with pancreatic or periampullary cancer who underwent PET/MRI before treatment. The imaging biomarkers were the minimal apparent diffusion coefficient (ADC min ), choline levels, standardized uptake values, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of the tumours. The relationships between these biomarkers and clinical TNM stage were evaluated using the Pearson test and the Mann-Whitney U test. The area under the receiver operating characteristic curve (AUROC) was used to evaluate accuracy. The correlation between the imaging biomarker and progression-free survival (PFS) was investigated using the Cox proportional hazards model. Results ADC min was significantly lower in N1 and TNM stage 3+ tumours. Choline levels significantly higher in T4 tumours. TLG was significantly higher in T4, N1 and TNM stage 3+ tumours. MTV was significantly higher in T4, N1, M1, and TNM stage 3+ tumours (all P