수술 가능한 췌장암 환자에서의 PET/CT 의 유용성: 림프절 전이 진단 및 생존율 예측

Abstract

Purpose: To evaluate the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for lymph node (LN) metastasis and the prognostic significance of FDG PET/CT LN parameters in patients with resectable pancreatic cancer.

Patients and Methods: Patients with resectable pancreatic cancer who underwent staging FDG PET/CT between May 2007 and September 2016 were retrospectively enrolled and analyzed through medical record and image reevaluation. The diagnostic accuracy of FDG PET/CT in predicting LN metastasis was evaluated and compared with that of enhanced CT. Prognostic variables, including LN parameters assessed by FDG PET/CT (standardized uptake value [SUV]LN and LN/tumor SUV ratio), that affect disease-free survival (DFS) and overall survival (OS) were evaluated by regression analysis.

Results: When predicting LN metastasis, FDG PET/CT showed greater sensitivity, positive predictive value, negative predictive value, and accuracy than enhanced CT. Among prognostic factors affecting DFS, PET-positive LN (p = 0.008) and LN/tumor SUV ratio (p = 0.003) were found to be significant by regression analysis. Among variables affecting OS, lympho-vascular invasion (p = 0.018) and LN/tumor SUV ratio (p = 0.046) were found to be significant.

Conclusion: FDG PET/CT showed higher diagnostic accuracy in predicting LN metastasis than enhanced CT in patients with resectable pancreatic cancer. Only LN/tumor SUV ratio of FDG PET/CT was an independent prognostic variable in both DFS and OS.