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Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study

  • Gastrointestinal
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Abstract

Objectives

To investigate usefulness of multiparametric fully integrated 18-FDG PET/MRI in predicting treatment response after chemotherapy for unresectable advanced gastric cancers (AGCs).

Methods

Eleven patients with unresectable AGCs underwent multiparametric 18-FDG PET/MRI examinations prior to chemotherapy. Perfusion parameters obtained via dynamic contrast-enhanced MRI, apparent diffusion coefficient values from diffusion-weighted images, and maximum standardized uptake values (SUVmax) from 18-FDG PET were measured. For parameters obtained from 18-FDG PET/MRI data, interobserver agreement was obtained using intraclass correlation coefficients (ICC) and chemotherapy response relationship was evaluated using the Mann–Whitney test and receiver operating characteristic analysis.

Results

After chemotherapy, six patients were classified into the responder group and five patients into the non-responder group. For all parameters, moderate to nearly perfect agreement was achieved (ICC = 0.452–0.911). K trans values (P = 0.018) and initial area under the curves (iAUCs) (P = 0.045) of gastric cancers were significantly higher in responder group than in non-responder group. The area under the curve was 0.917 for K trans and 0.867 for iAUC. However, SUVmax values were not significantly different between the two groups.

Conclusion

Multiparametric approach using fully integrated 18-FDG PET/MRI was shown to be feasible for patients with unresectable gastric cancers. In addition, K trans and iAUC values can be used as early predictive markers for chemotherapy response.

Key Points:

• Multiparametric 18-FDG PET/MRI is feasible for patients with unresectable advanced gastric cancer

• K trans and iAUC were significantly higher in the responder group of patients

• K trans , iAUC can be utilized as early predictive markers for chemotherapeutic response

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Acknowledgements

The scientific guarantor of this publication is Se Hyung Kim. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this study was supported by a grant from the Seoul National University Hospital Research Fund No. 03-2013-390. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all patients in this study. Methodology: prospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 28, Yeongon-dong, Jongno-gu, Seoul, 110-744, Korea

    Dong Ho Lee, Se Hyung Kim & Joon Koo Han

  2. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

    Seock-Ah Im, Do-Youn Oh & Tae-Yong Kim

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  1. Dong Ho Lee
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Correspondence to Se Hyung Kim.

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Lee, D.H., Kim, S.H., Im, SA. et al. Multiparametric fully-integrated 18-FDG PET/MRI of advanced gastric cancer for prediction of chemotherapy response: a preliminary study. Eur Radiol 26, 2771–2778 (2016). https://doi.org/10.1007/s00330-015-4105-5

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