Predictive value of maximum standardized uptake value (SUV_max) on ¹⁸F-FDG PET/CT in patients with locally advanced or metastatic pancreatic cancer

Purpose: We investigated the prognostic role of ¹⁸F-FDG PET/CT in the prediction of progression-free survival (PFS) and chemotherapeutic response in patients with locally advanced or metastatic pancreatic cancer. Methods: We enrolled 21 newly diagnosed patients with locally advanced or metastatic pancreatic cancer who underwent ¹⁸F-FDG PET/CT scanning before palliative gemcitabine-based chemotherapy between 2006 and 2012. Maximum standardized uptake value (SUV_max) of the primary tumor was measured by ¹⁸F-FDG PET/CT. Chemotherapeutic response was evaluated according to the Response Evaluation Criteria in Solid Tumors. Survival analysis was performed for time to progression using the Kaplan-Meier method. Cox proportional hazard models were used to determine independent prognostic factors. Results: All pancreatic tumors showed detectable FDG uptake (mean SUV_max = 6.8 T 3.0, range 2Y12) The mean SUV_max values among response groups showed no significant difference (P = 0.853) and chemotherapeutic response was not different according to SUV_max level (P = 0.807). PFS was significantly shorter in the high SUV_max (Q6.8) group than in the low SUV_max (G6.8) group (2.9 vs. 6 months, P = 0.012). Multivariate analysis revealed that SUV_max was an independent prognostic factor for predicting PFS (P = 0.046). Conclusions: Higher SUV _max of primary pancreatic tumor is associated with poor PFS and pretreatment SUV_max is an independent prognostic factor for predicting PFS in patients with locally advanced or metastatic pancreatic cancer who received gemcitabine-based palliative chemotherapy. However, pretreatment SUV_max is not associated with chemotherapeutic response.