Pretreatment 18F-FDG PET/CT in predicting the survival of patients with hepatic neuroendocrine tumors.

Abstract

Objective: To investigate the prognostic value of pretreatment 2-[¹⁸F]-fluoro-2-deoxy-d-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with hepatic neuroendocrine tumors (HNET).

Methods: In total, 41 patients were included in this study. PET-derived metabolic parameters, including maximum and mean standardized uptake values (SUV_max and SUV_mean, respectively), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), of the tumors were measured. Meanwhile, clinical data, including tumor pathological findings such as the Ki-67 index were also assessed. Progression-free survival (PFS) and overall survival (OS) were evaluated. Univariate and multivariate analyses were performed to predict the prognostic value of clinical variables and PET-derived metabolic parameters in HNET patients. Correlation between PET-derived metabolic parameters and Ki-67 was estimated.

Results: Univariate analyses revealed that among PET-derived metabolic parameters, SUV_max, SUV_mean, and TLG were significant prognostic factors for OS (P < .05). Among clinical variables, the Ki-67 index and radical surgical resection were significant factors for both PFS and OS (P < .05). In multivariate analyses, only Ki-67 index was an independent prognostic factor for both PFS and OS (P < .05). Ki-67 index presented correlates with SUV_max and SUV_mean (R = 0.566, P < .001, R = 0.493, P = .001, respectively).

Conclusions: In patients with HNET, the Ki-67 index was an independent prognostic factor for both PFS and OS, while SUV_max, SUV_mean, and TLG measured on pretreatment ¹⁸F-FDG PET/CT scans were prognostic factors for predicting OS. Ki-67 index also presented correlates with SUV_max and SUV_mean. ¹⁸F-FDG-PET may be useful as quantitative predicting prognostic imaging biomarkers, especially in poorly differentiated HNET.