['To assess whether intratumoral heterogeneity measured by (18)F-FDG PET texture analysis has potential as a prognostic imaging biomarker in patients with pancreatic ductal adenocarcinoma (PDAC).', 'We evaluated a cohort of 137 patients with newly diagnosed PDAC who underwent pretreatment (18)F-FDG PET/CT from January 2008 to December 2010. First-order (histogram indices) and higher-order (grey-level run length, difference, size zone matrices) textural features of primary tumours were extracted by PET texture analysis. Conventional PET parameters including metabolic tumour volume (MTV), total lesion glycolysis (TLG), and standardized uptake value (SUV) were also measured. To assess and compare the predictive performance of imaging biomarkers, time-dependent receiver operating characteristic (ROC) curves for censored survival data and areas under the ROC curve (AUC) at 2\xa0years after diagnosis were used. Associations between imaging biomarkers and overall survival were assessed using Cox proportional hazards regression models.', 'The best imaging biomarker for overall survival prediction was first-order entropy (AUC\u2009=\u20090.720), followed by TLG (AUC\u2009=\u20090.697), MTV (AUC\u2009=\u20090.692), and maximum SUV (AUC\u2009=\u20090.625). After adjusting for age, sex, clinical stage, tumour size and serum CA19-9 level, multivariable Cox analysis demonstrated that higher entropy (hazard ratio, HR, 5.59; P\u2009=\u20090.028) was independently associated with worse survival, whereas TLG (HR 0.98; P\u2009=\u20090.875) was not an independent prognostic factor.'] Does intratumoral heterogeneity of ( 18 ) F-FDG uptake predict survival in patients with pancreatic ductal adenocarcinoma?