Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

18F-FDG PET is Superior to WHO Grading as a Prognostic Tool in Neuroendocrine Neoplasms and Useful in Guiding PRRT: A Prospective 10-Year Follow-up Study.

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Systematically evaluating DOTATATE and FDG as PET immuno-imaging tracers of cardiovascular inflammation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Bone mass density following developmental exposures to perfluoroalkyl substances (PFAS): a longitudinal cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Association of apolipoprotein M and sphingosine-1-phosphate with brown adipose tissue after cold exposure in humans

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Bioorthogonal Click of Colloidal Gold Nanoparticles to Antibodies In vivo

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Accurate grading of patients with neuroendocrine neoplasms (NENs) is essential for risk stratification and optimal choice of therapy. Currently, grading is based on histologically assessed degree of tumor proliferation. The aim of the present study was to assess the long-term prognostic value of 18F-FDG PET imaging for risk stratification of NENs and compare it with tumor grading (World Health Organization 2010 classification). Methods: We conducted a prospective cohort study evaluating the prognostic value of 18F-FDG PET imaging and compared it with histologic grading. Enrolled were 166 patients of all grades and with histologically confirmed NENs of gastroenteropancreatic origin. The primary endpoint was overall survival (OS). Progression-free survival (PFS) was a secondary endpoint. In addition, OS in relation to peptide receptor radionuclide therapy (PRRT) was analyzed as an exploratory endpoint. The median follow-up time was 9.8 y. Results: Analysis of the whole cohort revealed that a positive 18F-FDG PET scan was associated with a shorter OS than a negative 18F-FDG PET scan (hazard ratio: 3.8; 95% CI: 2.4-5.9; P < 0.001). In G1 and G2 patients ( n = 140), a positive 18F-FDG PET scan was the only identifier of high risk for death (hazard ratio: 3.6; 95% CI, 2.2-5.9; P < 0.001). In multivariate analysis, 18F-FDG PET, G3 tumor, ≥2 liver metastases, and ≥2 prior therapies were independent prognostic factors for OS, and 18F-FDG PET, G3 tumor, and ≥3 liver metastases were independent prognostic factors for PFS. For patients receiving PRRT, 18F-FDG-negative cases had a significantly longer survival than 18F-FDG-positive cases, whereas no difference was identified for tumor grading. 18F-FDG-positive patients receiving PRRT had a significantly longer median survival than patients not receiving PRRT (4.4 vs. 1.4 y, P = 0.001), whereas no difference was seen for 18F-FDG-negative patients. Conclusion: 18F-FDG PET is useful for risk stratification of all NEN grades and is superior to histologic grading. 18F-FDG PET could differentiate G1 and G2 tumors into low- and high-risk groups. In the selection of therapy and for risk stratification of NEN patients, 18F-FDG PET status should be considered.

Original languageEnglish
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume62
Issue number6
Pages (from-to)808-815
Number of pages8
ISSN0161-5505
DOIs
Publication statusPublished - 1 Jun 2021

    Research areas

  • 18F-FDG PET, Ki-67, neuroendocrine tumors, peptide receptor radionuclide therapy (PRRT), prognosis, prospective study

ID: 61433572