Sooin Byeon, Bridget Abbott, Paul Roach, Dale L Bailey, Angela Chou, Sarah Maloney, Anthony J Gill, Jaswinder Samra, Anubhav Mittal, Sumit Sahni
{"title":"总病灶糖酵解是胰腺癌术前新辅助化疗患者化疗反应的一个有希望的预测指标。","authors":"Sooin Byeon, Bridget Abbott, Paul Roach, Dale L Bailey, Angela Chou, Sarah Maloney, Anthony J Gill, Jaswinder Samra, Anubhav Mittal, Sumit Sahni","doi":"10.1111/eci.70046","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There has been increased use of neoadjuvant chemotherapy (NAC) in resectable pancreatic ductal adenocarcinoma (PDAC) patients. [<sup>18</sup>F]fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scan is being frequently used to determine treatment response in PDAC patients undergoing NAC. Maximum standardized uptake value (SUV<sub>max</sub>) is conventionally used as an FDG-PET/CT parameter, but there are emerging parameters, such as total lesion glycolysis (TLG), which take into account mean standardized uptake (SUV<sub>mean</sub>) and metabolic tumour volume (MTV). This study compared the ability of emerging FDG-PET/CT parameters (i.e. SUV<sub>mean</sub>, MTV and TLG) to predict chemo-response compared to SUV<sub>max</sub>.</p><p><strong>Methods: </strong>In this single centre, retrospective study, NAC-treated PDAC patients (n = 74) for whom both pre- and post-NAC FDG-PET/CT scans were available were recruited. All scans were imported to a single analysis platform and reanalysed. Chemo-response was determined by the assessment of percentage viable tumour cells in the tumour bed. Statistical analysis was performed on the data.</p><p><strong>Results: </strong>A significant correlation was observed between post-treatment FDG-PET/CT scan parameters and viable cancer cells in the tumour bed, with TLG showing a higher degree of correlation (r = .3131) compared to all other parameters (r = .2722-.3008). The percentage decrease in the TLG (post-NAC scan vs. pre-NAC scan) demonstrated the highest degree of correlation with viable cancer cells in the tumour bed (r = -.3444) and had a statistically significant (p = .0157) effect between NAC responders (Median = 80.57) and non-responders (Median = 65.16). The difference between TLG (post-NAC scan vs. pre-NAC scan) was shown to be an independent prognostic indicator for overall survival (hazard ratio = .5033, p = .0361).</p><p><strong>Conclusion: </strong>TLG was shown to be a superior predictor of chemo-response and patient prognosis compared to all other FDG-PET/CT parameters in PDAC patients treated with NAC.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70046"},"PeriodicalIF":4.4000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Total lesion glycolysis is a promising predictor of chemo-response in pancreatic cancer patients treated with neoadjuvant chemotherapy prior to surgery.\",\"authors\":\"Sooin Byeon, Bridget Abbott, Paul Roach, Dale L Bailey, Angela Chou, Sarah Maloney, Anthony J Gill, Jaswinder Samra, Anubhav Mittal, Sumit Sahni\",\"doi\":\"10.1111/eci.70046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There has been increased use of neoadjuvant chemotherapy (NAC) in resectable pancreatic ductal adenocarcinoma (PDAC) patients. [<sup>18</sup>F]fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scan is being frequently used to determine treatment response in PDAC patients undergoing NAC. Maximum standardized uptake value (SUV<sub>max</sub>) is conventionally used as an FDG-PET/CT parameter, but there are emerging parameters, such as total lesion glycolysis (TLG), which take into account mean standardized uptake (SUV<sub>mean</sub>) and metabolic tumour volume (MTV). This study compared the ability of emerging FDG-PET/CT parameters (i.e. SUV<sub>mean</sub>, MTV and TLG) to predict chemo-response compared to SUV<sub>max</sub>.</p><p><strong>Methods: </strong>In this single centre, retrospective study, NAC-treated PDAC patients (n = 74) for whom both pre- and post-NAC FDG-PET/CT scans were available were recruited. All scans were imported to a single analysis platform and reanalysed. Chemo-response was determined by the assessment of percentage viable tumour cells in the tumour bed. Statistical analysis was performed on the data.</p><p><strong>Results: </strong>A significant correlation was observed between post-treatment FDG-PET/CT scan parameters and viable cancer cells in the tumour bed, with TLG showing a higher degree of correlation (r = .3131) compared to all other parameters (r = .2722-.3008). The percentage decrease in the TLG (post-NAC scan vs. pre-NAC scan) demonstrated the highest degree of correlation with viable cancer cells in the tumour bed (r = -.3444) and had a statistically significant (p = .0157) effect between NAC responders (Median = 80.57) and non-responders (Median = 65.16). The difference between TLG (post-NAC scan vs. pre-NAC scan) was shown to be an independent prognostic indicator for overall survival (hazard ratio = .5033, p = .0361).</p><p><strong>Conclusion: </strong>TLG was shown to be a superior predictor of chemo-response and patient prognosis compared to all other FDG-PET/CT parameters in PDAC patients treated with NAC.</p>\",\"PeriodicalId\":12013,\"journal\":{\"name\":\"European Journal of Clinical Investigation\",\"volume\":\" \",\"pages\":\"e70046\"},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2025-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Clinical Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/eci.70046\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/eci.70046","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Total lesion glycolysis is a promising predictor of chemo-response in pancreatic cancer patients treated with neoadjuvant chemotherapy prior to surgery.
Background: There has been increased use of neoadjuvant chemotherapy (NAC) in resectable pancreatic ductal adenocarcinoma (PDAC) patients. [18F]fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scan is being frequently used to determine treatment response in PDAC patients undergoing NAC. Maximum standardized uptake value (SUVmax) is conventionally used as an FDG-PET/CT parameter, but there are emerging parameters, such as total lesion glycolysis (TLG), which take into account mean standardized uptake (SUVmean) and metabolic tumour volume (MTV). This study compared the ability of emerging FDG-PET/CT parameters (i.e. SUVmean, MTV and TLG) to predict chemo-response compared to SUVmax.
Methods: In this single centre, retrospective study, NAC-treated PDAC patients (n = 74) for whom both pre- and post-NAC FDG-PET/CT scans were available were recruited. All scans were imported to a single analysis platform and reanalysed. Chemo-response was determined by the assessment of percentage viable tumour cells in the tumour bed. Statistical analysis was performed on the data.
Results: A significant correlation was observed between post-treatment FDG-PET/CT scan parameters and viable cancer cells in the tumour bed, with TLG showing a higher degree of correlation (r = .3131) compared to all other parameters (r = .2722-.3008). The percentage decrease in the TLG (post-NAC scan vs. pre-NAC scan) demonstrated the highest degree of correlation with viable cancer cells in the tumour bed (r = -.3444) and had a statistically significant (p = .0157) effect between NAC responders (Median = 80.57) and non-responders (Median = 65.16). The difference between TLG (post-NAC scan vs. pre-NAC scan) was shown to be an independent prognostic indicator for overall survival (hazard ratio = .5033, p = .0361).
Conclusion: TLG was shown to be a superior predictor of chemo-response and patient prognosis compared to all other FDG-PET/CT parameters in PDAC patients treated with NAC.
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EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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