TY - JOUR
T1 - [18F]FDG PET/MRI enables early chemotherapy response prediction in pancreatic ductal adenocarcinoma
AU - Harder, Felix N.
AU - Jungmann, Friederike
AU - Kaissis, Georgios A.
AU - Lohöfer, Fabian K.
AU - Ziegelmayer, Sebastian
AU - Havel, Daniel
AU - Quante, Michael
AU - Reichert, Maximillian
AU - Schmid, Roland M.
AU - Demir, Ihsan Ekin
AU - Friess, Helmut
AU - Wildgruber, Moritz
AU - Siveke, Jens
AU - Muckenhuber, Alexander
AU - Steiger, Katja
AU - Weichert, Wilko
AU - Rauscher, Isabel
AU - Eiber, Matthias
AU - Makowski, Marcus R.
AU - Braren, Rickmer F.
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021
Y1 - 2021
N2 - Purpose: In this prospective exploratory study, we evaluated the feasibility of [18F]fluorodeoxyglucose ([18F]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 [18F]FDG PET/MRI before and two weeks after onset of chemotherapy. Response per RECIST1.1 was then assessed at 3 months [18F]FDG PET/MRI-derived parameters (MTV50%, TLG50%, MTV2.5, TLG2.5, SUVmax, SUVpeak, ADCmax, ADCmean and ADCmin) 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 ∆MTV50% and ∆ADC (≥ 20% and 15%, respectively) and a decrease in ∆TLG50% (≤ 20%) at 2 weeks after chemotherapy onset enabled prediction of responders and non-responders, respectively. Parameter combinations (∆TLG50% and ∆ADCmax or ∆MTV50% and ∆ADCmax) further improved discrimination. Conclusion: Multiparametric [18F]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.
AB - Purpose: In this prospective exploratory study, we evaluated the feasibility of [18F]fluorodeoxyglucose ([18F]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 [18F]FDG PET/MRI before and two weeks after onset of chemotherapy. Response per RECIST1.1 was then assessed at 3 months [18F]FDG PET/MRI-derived parameters (MTV50%, TLG50%, MTV2.5, TLG2.5, SUVmax, SUVpeak, ADCmax, ADCmean and ADCmin) 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 ∆MTV50% and ∆ADC (≥ 20% and 15%, respectively) and a decrease in ∆TLG50% (≤ 20%) at 2 weeks after chemotherapy onset enabled prediction of responders and non-responders, respectively. Parameter combinations (∆TLG50% and ∆ADCmax or ∆MTV50% and ∆ADCmax) further improved discrimination. Conclusion: Multiparametric [18F]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.
KW - Chemotherapy
KW - PDAC
KW - PET/MRI
KW - Response prediction
UR - http://www.scopus.com/inward/record.url?scp=85111521719&partnerID=8YFLogxK
U2 - 10.1186/s13550-021-00808-4
DO - 10.1186/s13550-021-00808-4
M3 - Article
AN - SCOPUS:85111521719
SN - 2191-219X
VL - 11
JO - EJNMMI Research
JF - EJNMMI Research
IS - 1
M1 - 70
ER -