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Abstract:
Objective
FDG-PET provides quantitative information regarding the tumor glucose metabolism which is useful for the
clinical diagnosis of tumor diseases. It is said that the amount of tumor stroma correlates with prognosis of
patients with cancer. FDG accumulates in cancer cells but does not accumulate so much in stroma tissues.
So cancer tissue with abundant stroma might show relatively lower accumulation of FDG than that with scanty
stroma. We estimated the amount of tumor stroma with FDG-PET (STRpet), and evaluated prognosis of
patients using STRpet after surgery of pancreatic cancer.
Methods
Sixteen pre-surgery patients with either proven or suspected primary pancreatic cancer underwent FDG-
PET/CT. The pathologically confirmation found out 13 malignancy in all cases. The STRpet in tumor was
evaluated for the 13 cases with the following equation:
STRpet = [Mean value of spherical VOI of 10mm in radius with SUVmax in the center of it] / [SUVmax]
The tumor with abundant stroma might be low STRpet, because the tumor cell accumulates FDG avidly but
stroma does not so much. According to pathological findings, the stroma of tumors (STRpatho) were
quantitatively classified in the following 3 types (Scirrhous type: abundant stroma, Intermediate type: a type
intermediate between the scirrhous type and the medullary type, and Medullary type: scanty stroma).
The STRpet were statistically compared with STRpatho using the Mann-Whitney's U test. The 1-year disease-
free survival (DFS) and overall survival (OS) for STRPEt and STRpatho were calculated using Kaplan-Meier
method.
Results
There is no patient with Medullary type in our cases. Statistically-significant difference was observed in
STRpet between Scirrhous type and Intermediate type (p<0.04). Scirrhous type has a lower STRpet than
Intermediate type. The patients with STRpet<0.7 or scirrhous type had markedly lower 1-year DFS rate than
those with STRpet^O.7 or intermediate type (0% vs. 50% p<0.03, 0% vs. 57% p<0.01). The patients with
STRpet<0.7 or scirrhous type had markedly lower OS rate than those with STRpet^0.7 or intermediate type
(0% vs. 50% p<0.05, 0% vs. 57% p<0.03). The STRPEt could make
a prediction of prognosis with FDG-PET.
会議概要（会議名, 開催地, 会期, 主催者等）
Annual Congress of the European Association of Nuclear Medicine
Estimation of the amount of tumor stroma as a prognostic factor for pancreatic cancer using FDG-PET
