Prediction of tumour grade and survival outcome using pre-treatment PET- and MRI-derived imaging features in patients wi
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ONCOLOGY
Prediction of tumour grade and survival outcome using pre-treatment PET- and MRI-derived imaging features in patients with resectable pancreatic ductal adenocarcinoma Vincent Dunet 1 & Nermin Halkic 2 & Christine Sempoux 3 & Nicolas Demartines 2 & Michael Montemurro 4 & John O. Prior 5 & Sabine Schmidt 1 Received: 2 June 2020 / Revised: 29 June 2020 / Accepted: 12 August 2020 # The Author(s) 2020
Abstract Objectives To perform a correlation analysis between histopathology and imaging in patients with previously untreated pancreatic ductal adenocarcinoma (PDAC) and to determine the prognostic values of clinical, histological, and imaging parameters regarding overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS). Methods This single-centre study prospectively included 61 patients (32 males; median age, 68.0 years [IQR, 63.0–75.0 years]) with histologically confirmed PDAC and following surgical resection who preoperatively underwent 18F-FDG PET/CT and DWMRI. On whole lesions, we measured, using a 42% SUVmax threshold volume of interest (VOI), the following quantitative parameters: mean and maximum standardised uptake values (SUVmean and SUVmax), total lesion glycolysis (TLG), metabolic tumour volume (MTV), mean and minimum apparent diffusion coefficient (ADCmean and ADCmin), diffusion total volume (DTV), and MTV/ADCmin ratio. Spearman’s correlation analysis was performed to assess relationships between these markers and histopathological findings from surgical specimens (stage; grade; resection quality; and vascular, perineural, and lymphatic invasion). Kaplan-Meier and Cox hazard ratio methods were used to evaluate the impacts of imaging parameters on OS (n = 41), DSS (n = 36), and PFS (n = 41). Results Inverse correlations between ADCmin and SUVmax (rho = − 0.34; p = 0.0071), and between SUVmean and ADCmean (rho = − 0.29; p = 0.026) were identified. ADCmin was inversely correlated with tumour grade (rho = − 0.40; p = 0.0015). MTV was an independent predictive factor for OS and DSS, while DTV was an independent predictive factor for PFS. Conclusion In previously untreated PDAC, ADC and SUV values are correlated. Combining PET-MRI metrics may help predict PDAC grade and patients’ survival.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00330-020-07191-z) contains supplementary material, which is available to authorized users. * John O. Prior [email protected] 1
2
Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
3
Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
4
Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
5
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of La
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