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Significance of Metabolic Tumor Volume and Total Lesion Glycolysis Measured Using ¹⁸F-FDG PET/CT in Locally Advanced and Metastatic Gallbladder Carcinoma

 You Jin Chun  ;  Hei-Cheul Jeung  ;  Hyung Soon Park  ;  Ji Soo Park  ;  Sun Young Rha  ;  Hye Jin Choi  ;  Jae-Hoon Lee  ;  Tae Joo Jeon 
 YONSEI MEDICAL JOURNAL, Vol.60(7) : 604-610, 2019 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Fluorodeoxyglucose F18* ; Gallbladder Neoplasms/diagnostic imaging ; Gallbladder Neoplasms/metabolism* ; Gallbladder Neoplasms/pathology* ; Glycolysis* ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Positron Emission Tomography Computed Tomography* ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Tumor Burden*
Gallbladder neoplasms ; metabolic tumor volume ; metastasis ; prognosis ; ¹⁸F-FDG PET/CT
PURPOSE: This study aimed to determine the prognostic value of new quantitative parameters of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), including metabolic tumor volume (MTV), in patients with locally advanced and metastatic gallbladder cancer (GBC).

MATERIALS AND METHODS: In total, 83 patients initially diagnosed with locally advanced and metastatic GBC and who underwent ¹⁸F-FDG PET/CT at the time of initial diagnosis were retrospectively reviewed. The metabolic volume-based PET parameters of primary tumors and metastatic lesions were measured, including maximum and average standardized uptake values (SUV), MTV, and total lesion glycolysis. An overall survival (OS) analysis was performed using the Kaplan-Meier method with PET and clinical parameters. A Cox proportional hazards regression analysis was performed to determine independent prognostic factors.

RESULTS: In univariate analysis, pathologic differentiation (p<0.001), performance status (PS; p=0.003), C-reactive protein (CRP) level (p=0.009), and PET-related SUVmt max (the highest SUV among the metastatic lesions) (p=0.040) and MTVtotal (the sum of the MTVs of both the primary and metastatic lesions) (p=0.031), were significant for OS. In multivariate analysis, MTVtotal (hazard ratio: 2.07; 95% confidence interval: 1.23-3.48; p=0.006) remained significant for the prediction of OS, as did differentiation (p=0.001), PS (p=0.001), and CRP (p=0.039).

CONCLUSION: In locally advanced and metastatic GBC, volume-based PET/CT parameters of the total tumor burden of malignancy, such as MTVtotal, were found to be useful for the identification of patients with poor prognosis.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Ji Soo(박지수) ORCID logo https://orcid.org/0000-0002-0023-7740
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Jeon, Tae Joo(전태주) ORCID logo https://orcid.org/0000-0002-7574-6734
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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