PMID- 35729738 OWN - NLM STAT- MEDLINE DCOM- 20220729 LR - 20221015 IS - 1365-2826 (Electronic) IS - 0953-8194 (Print) IS - 0953-8194 (Linking) VI - 34 IP - 7 DP - 2022 Jul TI - Volumetric parameters from [(18) F]FDG PET/CT predicts survival in patients with high-grade gastroenteropancreatic neuroendocrine neoplasms. PG - e13170 LID - 10.1111/jne.13170 [doi] LID - e13170 AB - A positive fluorine-18 labelled 2-deoxy-2-fluoroglucose ([(18) F]FDG) positron emission tomography/computed tomography (PET/CT) has been associated with more aggressive disease and less differentiated neuroendocrine neoplasms (NEN). Although a high maximum standardized uptake value (SUV(max) ) predicts poor outcome in NEN, volumetric parameters from [(18) F]FDG PET have not been evaluated for prognostication in a pure high-grade gastroenteropancreatic (GEP) NEN cohort. In this retrospective observational study, we evaluated the volumetric PET parameters total metabolic tumour volume (tMTV) and total total lesion glycolysis (tTLG) for independent prognostication of overall survival (OS). High-grade GEP NEN patients with [(18) F]FDG PET/CT examination and biopsy within 90 days were included. Total MTV and tTLG were calculated using an adaptive thresholding software. Patients were dichotomised into low and high metabolic groups based on median tMTV and tTLG. OS was compared using Kaplan-Meier estimator and log-rank test. Uni and multivariable Cox regression was used to estimate effect sizes and adjust for tumour differentiation and SUV(max) . Sixty-six patients (median age 64 years) were included with 14 NET G3 and 52 NEC cases after histological re-evaluation. Median tMTV was 208 cm(3) and median tTLG 1899 g. Median OS in the low versus high tMTV-group was 21.2 versus 5.7 months (HR 2.53, p = 0.0007) and 22.8 versus 5.7 months (HR 2.42, p = 0.0012) in the tTLG-group. Adjusted for tumour differentiation and SUV(max) , tMTV and tTLG still predicted for poor OS, and both tMTV and tTLG were stronger prognostic parameters than SUV(max) . Both regression models showed a strong association between volumetric parameters and OS for both neuroendocrine tumours (NET) G3 and neuroendocrine carcinomas (NEC). OS for the tTLG low metabolic NEC was much higher than for the tTLG high metabolic NET G3 (18.3 vs. 5.7 months). High-grade GEP NEN patients with high tMTV or tTLG had a worse OS regardless of tumour differentiation (NET G3 or NEC). Volumetric PET parameters were stronger prognostic parameters than SUV(max) . CI - (c) 2022 The Authors. Journal of Neuroendocrinology published by John Wiley & Sons Ltd on behalf of British Society for Neuroendocrinology. FAU - Langen Stokmo, Henning AU - Langen Stokmo H AUID- ORCID: 0000-0002-2861-0340 AD - Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway. AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. FAU - Aly, Mahmoud AU - Aly M AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. AD - Department of Radiology, Asyut University Hospital, Asyut, Egypt. FAU - Bowitz Lothe, Inger Marie AU - Bowitz Lothe IM AD - Department of Pathology, Oslo University Hospital, Oslo, Norway. FAU - Borja, Austin J AU - Borja AJ AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. AD - Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Mehdizadeh Seraj, Siavash AU - Mehdizadeh Seraj S AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Ghorpade, Rina AU - Ghorpade R AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Miao, Xuan AU - Miao X AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Hjortland, Geir Olav AU - Hjortland GO AD - Department of Oncology, Oslo University Hospital, Oslo, Norway. FAU - Malinen, Eirik AU - Malinen E AD - Department of Medical Physics, Oslo University Hospital, Oslo, Norway. AD - Department of Physics, University of Oslo, Oslo, Norway. FAU - Sorbye, Halfdan AU - Sorbye H AD - Department of Oncology, Haukeland University Hospital, Bergen, Norway. AD - Department of Clinical Science, University of Bergen, Bergen, Norway. FAU - Werner, Thomas J AU - Werner TJ AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Alavi, Abass AU - Alavi A AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. FAU - Revheim, Mona-Elisabeth AU - Revheim ME AD - Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway. AD - Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. AD - Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20220621 PL - United States TA - J Neuroendocrinol JT - Journal of neuroendocrinology JID - 8913461 RN - 0Z5B2CJX4D (Fluorodeoxyglucose F18) SB - IM MH - *Fluorodeoxyglucose F18/metabolism MH - Humans MH - Middle Aged MH - *Neuroendocrine Tumors/diagnostic imaging MH - Positron Emission Tomography Computed Tomography/methods MH - Prognosis MH - Tumor Burden PMC - PMC9539477 OTO - NOTNLM OT - [18F]FDG PET/CT OT - high-grade gastroenteropancreatic neuroendocrine neoplasia OT - overall survival OT - prognosis OT - volumetric parameters COIS- H.L.S have received consultancy fees from Siemens Healthineers. EDAT- 2022/06/23 06:00 MHDA- 2022/07/30 06:00 PMCR- 2022/10/07 CRDT- 2022/06/22 00:13 PHST- 2022/04/12 00:00 [revised] PHST- 2022/02/10 00:00 [received] PHST- 2022/05/23 00:00 [accepted] PHST- 2022/06/23 06:00 [pubmed] PHST- 2022/07/30 06:00 [medline] PHST- 2022/06/22 00:13 [entrez] PHST- 2022/10/07 00:00 [pmc-release] AID - JNE13170 [pii] AID - 10.1111/jne.13170 [doi] PST - ppublish SO - J Neuroendocrinol. 2022 Jul;34(7):e13170. doi: 10.1111/jne.13170. Epub 2022 Jun 21.