Lesion-by-lesion correlation between uptake at FDG PET and the Ki67 proliferation index in resected pancreatic neuroendocrine tumors.

Abstract

BACKGROUND:

Ki67 proliferation index and tumor uptake on 18fluorodeoxyglucose positron-emitting tomography (FDG-PET) could be correlated in pancreatic neuroendocrine tumors (PanNET), but the evaluation of the former is subject to tumor heterogeneity.

AIMS:

Explore the correlation between Ki67 and FDG-PET uptake at the lesion scale in PanNET.

METHODS:

We identified target lesions ≥10 mm in patients operated on for a PanNET and/or associated metastases with preoperative FDG-PET and without neoadjuvant treatment. We assessed the lesion-by-lesion correlation between Ki67 and the tumor-to-liver SUVmax ratio (SUVmax T/L), and between pathological grade (G) and metabolic grade (mG) (mG1, SUVmax T/L ≤ 1, mG2, SUVmax T/L 1-2.3 and mG3, SUVmax T/L > 2.3).

RESULTS:

Twenty-one patients underwent pancreatic (n = 12), liver (n = 2) or combined surgery (n = 7). Overall, 36 target lesions (21 primary PanNET, 13 liver metastases and 2 lymph-node metastases) were identified, of median Ki67 4%. Ki67 correlated with SUVmax T/L (r = 0.55, p < 0.001). Median SUVmax T/L was 0.76, 1.41 and 2.67 for lesions G1, G2 and G3, respectively (p = 0.005). Median Ki67 was 1, 4 and 25 for lesions mG1, mG2 and mG3, respectively (p = 0.005).

CONCLUSIONS:

Uptake on FDG-PET could predict the pathological grade of PanNET lesions. Hence, FDG-PET could supplement pathological evaluation of tumor biological aggressiveness and could guide the choice of the most relevant lesions to biopsy.

• Authors: Louis de Mestier, Margot Armani, Jérôme Cros, Olivia Hentic, Vinciane Rebours, Guillaume Cadiot, Alain Sauvanet, Anne Couvelard, Rachida Lebtahi, Philippe Ruszniewski
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 51 Issue 12 Pg. 1720-1724 (12 2019) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 31350186 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers, Tumor
• Ki-67 Antigen
• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Biomarkers, Tumor (analysis)
• Cell Proliferation
• Female
• Fluorodeoxyglucose F18 (pharmacology)
• Humans
• Immunohistochemistry
• Ki-67 Antigen (analysis)
• Liver Neoplasms (diagnostic imaging, secondary)
• Lymphatic Metastasis (diagnostic imaging)
• Male
• Middle Aged
• Neuroendocrine Tumors (pathology, surgery)
• Pancreatectomy (methods, statistics & numerical data)
• Pancreatic Neoplasms (pathology, surgery)
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals (pharmacology)
• Reproducibility of Results