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

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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). Ktrans 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 Ktrans 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, Ktrans 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 • Ktransand iAUC were significantly higher in the responder group of patients • Ktrans, iAUC can be utilized as early predictive markers for chemotherapeutic response

Original languageEnglish
Pages (from-to)2771-2778
Number of pages8
JournalEuropean Radiology
Issue number8
StatePublished - 1 Aug 2016


  • Advanced gastric cancer
  • Dynamic contrast-enhanced MRI
  • Multiparametric 18F-fluorodexoyglucose PET/MRI
  • Palliative chemotherapy
  • Response prediction

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