Nucl Med Mol Imaging.  2012 Sep;46(3):201-206.

Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

• Yoo J
• Choi JY
• Lee KT
• Heo JS
• Park SB
• Moon SH
• Choe YS
• Lee KH
• Kim BT

Abstract

PURPOSE
We investigated the prognostic values of volume-based metabolic parameters by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder carcinoma patients and compared them with other prognostic parameters.
MATERIALS AND METHODS
We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and undergoing 18F-FDG PET/CT. Various metabolic volume-based PET parameters of primary tumors, including maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan-Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed.
RESULTS
Of the 44 enrolled patients, cancer- or treatment-related death occurred in 30 (68.2 %). The mean clinical follow-up period was 22.2+/-10.4 m (range, 0.6-35.9 m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P<0.001), treatment modality (P<0.001), MTV (cutoff = 135 cm3, P=0.001), and TLG (cutoff = 7,090, P<0.05) were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR)=2.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P=0.001) and TLG (HR=2.930; P<0.05) were independent prognostic factors for predicting overall survival.
CONCLUSIONS
In gallbladder cancer, TLG of the primary tumor, a volume-based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage.

Keyword

Gallbladder carcinoma; Prognosis; 18F-FDG; PET/CT; Metabolic tumor volume; Total lesion glycolysis

MeSH Terms

Fluorodeoxyglucose F18
Follow-Up Studies
Gallbladder
Gallbladder Neoplasms
Glycolysis
Humans
Multivariate Analysis
Positron-Emission Tomography
Prognosis
Tumor Burden
Fluorodeoxyglucose F18