Prognostic Value of Pretherapeutic Primary Tumour MTV from [18F]FDG PET in Radically Treated Cervical Cancer Patients

The aim of this study was to assess the usefulness of pretherapeutic primary tumor metabolic tumor volume (MTV) in the prognosis of radically treated cervical cancer patients. Retrospective, single-centre analysis was performed on a group of 508 cervical cancer patients. All patients underwent a pretreatment [18F]FDG PET/CT study for the assessment of the disease stage. Several PET-derived parameters—namely, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), total lesion glycolysis (TLG) and MTV, as well as the clinical parameters, were analysed in terms of the overall survival (OS), event-free survival (EFS), locoregional control (LRC) and freedom from distant metastases (FFDM). Hyperthermia and brachytherapy were prognostic for EFS, OS, and LRC.FIGO stage > II showed a significant effect on EFS, OS, and FFDM. Moreover, hysterectomy was prognostic for OS and histology was prognostic for FFDM. From the PET-derived parameters only MTV of the primary tumour had a significant influence on OS (cutoff point: >12.7 mL, HR: 2.8, 1.75–4.48 95% CI, p < 0.001), LRC (cutoff point: >13.7 mL, HR 2.82, 1.42–5.61 95% CI, p = 0.003), EFS (cutoff point: >10.4 mL, HR: 2.57, 1.67–3.97 95% CI, p < 0.001) and FFDM (cutoff point: >10.4 mL, HR: 5.04, 1.82–13.99 95%CI, p = 0.002). The pretreatment of MTV in primary tumour is the only independent prognostic parameter in OS, LRC, EFS, and FFDM in radically treated cervical cancer patients and should be used in clinical practice in assessing prognosis in these patients.

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Diagnostic efficiency of whole-body 18F-FDG PET/MRI, MRI alone, and SUV and ADC values in staging of primary uterine cervical cancer

Cancer Imaging ◽

10.1186/s40644-020-00372-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Aida Steiner ◽

Sara Narva ◽

Irina Rinta-Kiikka ◽

Sakari Hietanen ◽

Johanna Hynninen ◽

...

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Distant Metastases ◽

Added Value ◽

Whole Body ◽

Definitive Treatment ◽

Nodal Involvement ◽

Local Tumor ◽

Tumor Spread

Abstract Background The use of PET/MRI for gynecological cancers is emerging. The purpose of this study was to assess the additional diagnostic value of PET over MRI alone in local and whole-body staging of cervical cancer, and to evaluate the benefit of standardized uptake value (SUV) and apparent diffusion coefficient (ADC) in staging. Methods Patients with histopathologically-proven cervical cancer and whole-body 18F-FDG PET/MRI obtained before definitive treatment were retrospectively registered. Local tumor spread, nodal involvement, and distant metastases were evaluated using PET/MRI or MRI dataset alone. Histopathology or clinical consensus with follow-up imaging were used as reference standard. Tumor SUVmax and ADC were measured and SUVmax/ADC ratio calculated. Area under the curve (AUC) was determined to predict diagnostic performance and Mann-Whitney U test was applied for group comparisons. Results In total, 33 patients who underwent surgery (n = 23) or first-line chemoradiation (n = 10) were included. PET/MRI resulted in higher AUC compared with MRI alone in detecting parametrial (0.89 versus 0.73), vaginal (0.85 versus 0.74), and deep cervical stromal invasion (0.96 versus 0.74), respectively. PET/MRI had higher diagnostic confidence than MRI in identifying patients with radical cone biopsy and no residual at hysterectomy (sensitivity 89% versus 44%). PET/MRI and MRI showed equal AUC for pelvic nodal staging (both 0.73), whereas AUC for distant metastases was higher using PET/MRI (0.80 versus 0.67). Tumor SUVmax/ADC ratio, but not SUVmax or ADC alone, was significantly higher in the presence of metastatic pelvic lymph nodes (P < 0.05). Conclusions PET/MRI shows higher accuracy than MRI alone for determining local tumor spread and distant metastasis emphasizing the added value of PET over MRI alone in staging of cervical cancer. Tumor SUVmax/ADC ratio may predict pelvic nodal involvement.

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Cervical Cancer: Associations between Metabolic Parameters and Whole Lesion Histogram Analysis Derived from Simultaneous 18F-FDG-PET/MRI

Contrast Media & Molecular Imaging ◽

10.1155/2018/5063285 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Hans-Jonas Meyer ◽

Sandra Purz ◽

Osama Sabri ◽

Alexey Surov

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Metabolic Tumor Volume ◽

Total Lesion Glycolysis ◽

Histogram Analysis ◽

Whole Body ◽

Standardized Uptake Values ◽

Positron Emission ◽

18F Fdg ◽

Magnetic Resonance Imaging Mri

Multimodal imaging has been increasingly used in oncology, especially in cervical cancer. By using a simultaneous positron emission (PET) and magnetic resonance imaging (MRI, PET/MRI) approach, PET and MRI can be obtained at the same time which minimizes motion artefacts and allows an exact imaging fusion, which is especially important in anatomically complex regions like the pelvis. The associations between functional parameters from MRI and 18F-FDG-PET reflecting different tumor aspects are complex with inconclusive results in cervical cancer. The present study correlates histogram analysis and 18F-FDG-PET parameters derived from simultaneous FDG-PET/MRI in cervical cancer. Overall, 18 female patients (age range: 32–79 years) with histopathologically confirmed squamous cell cervical carcinoma were retrospectively enrolled. All 18 patients underwent a whole-body simultaneous 18F-FDG-PET/MRI, including diffusion-weighted imaging (DWI) using b-values 0 and 1000 s/mm2. Apparent diffusion coefficient (ADC) histogram parameters included several percentiles, mean, min, max, mode, median, skewness, kurtosis, and entropy. Furthermore, mean and maximum standardized uptake values (SUVmean and SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were estimated. No statistically significant correlations were observed between SUVmax or SUVmean and ADC histogram parameters. TLG correlated inversely with p25 (r=−0.486,P=0.041), p75 (r=−0.490,P=0.039), p90 (r=−0.513,P=0.029), ADC median (r=−0.497,P=0.036), and ADC mode (r=−0.546,P=0.019). MTV also showed significant correlations with several ADC parameters: mean (r=−0.546,P=0.019), p10 (r=−0.473,P=0.047), p25 (r=−0.569,P=0.014), p75 (r=−0.576,P=0.012), p90 (r=−0.585,P=0.011), ADC median (r=−0.577,P=0.012), and ADC mode (r=−0.597,P=0.009). ADC histogram analysis and volume-based metabolic 18F-FDG-PET parameters are related to each other in cervical cancer.

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The effect of different segmentation methods on primary tumour metabolic volume assessed in 18F-FDG-PET/CT in patients with cervical cancer, for radiotherapy planning

Współczesna Onkologia ◽

10.5114/wo.2019.89248 ◽

2019 ◽

Vol 23 (3) ◽

pp. 183-186

Author(s):

Paulina Cegła ◽

Ewa Burchardt ◽

Ewa Wierzchosławska ◽

Andrzej Roszak ◽

Witold Cholewiński

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Primary Tumour ◽

Radiotherapy Planning ◽

Pet Ct ◽

Segmentation Methods ◽

18F Fdg ◽

Fdg Pet Ct ◽

Metabolic Volume

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Chest CT and Whole-Body 18F-FDG PET Are Cost-Effective in Screening for Distant Metastases in Head and Neck Cancer Patients

Journal of Nuclear Medicine ◽

10.2967/jnumed.109.067371 ◽

2010 ◽

Vol 51 (2) ◽

pp. 176-182 ◽

Cited By ~ 43

Author(s):

C. A. Uyl-de Groot ◽

A. Senft ◽

R. de Bree ◽

C. R. Leemans ◽

O. S. Hoekstra

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Fdg Pet ◽

Cost Effective ◽

Distant Metastases ◽

Chest Ct ◽

Whole Body ◽

18F Fdg

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Standardized uptake value and metabolic tumor volume measured by 18F FDG PET/CT are sensitive biomarkers for the presence of lymph node metastasis in patients with cervical carcinoma

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) ◽

10.1016/j.remnie.2014.08.001 ◽

2014 ◽

Vol 33 (5) ◽

pp. 268-273

Author(s):

G.U. Vural ◽

B.E. Akkas ◽

B.B. Demirel

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Fdg Pet ◽

Tumor Volume ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

Node Metastasis ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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The Preoperative Maximum Standardized Uptake Value Measured by 18F-FDG PET/CT as an Independent Prognostic Factor of Overall Survival in Endometrial Cancer Patients

BioMed Research International ◽

10.1155/2014/234813 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Malgorzata Walentowicz-Sadlecka ◽

Bogdan Malkowski ◽

Pawel Walentowicz ◽

Pawel Sadlecki ◽

Andrzej Marszalek ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

High Risk ◽

Cancer Patients ◽

Fdg Pet ◽

Standardized Uptake Value ◽

Maximum Standardized Uptake Value ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Purpose. The aim of this study was to determine if the preoperative maximum standardized uptake value (SUVmax) measured by 18F-FDG PET/CT in the primary tumor has prognostic value in the group of patients with endometrial cancer.Patients, Materials, and Methods. A total of one hundred one consecutive endometrial cancer patients, age range 40–82 years (mean 62 years) and FIGO I–IV stage, who underwent 18-FDG-PET/CT within two weeks prior radical surgery, were enrolled to the study. The maximum SUV was measured and compared with the clinicopathologic features of surgical specimens. The relationship between SUVmax and overall survival was analyzed.Results. The mean preoperative SUVmax was 14.34; range (3.90–33.80) and was significantly lower for FIGO I than for higher stages (P=0.0012), as well as for grade 1 than for grade 2 and 3 (P=0.018), deep myometrial invasion (P=0.0016) and for high risk group (P=0.0004). The analysis of survival ROC curve revealed SUVmax cut-off value of 17.7 to predict high risk of recurrence. Endometrial cancer patients with SUVmax higher than 17.7 characterized by lower overall survival.Conclusion. The preoperative SUVmax measured by 18F-FDG PET/CT is considered as an important indicator reflecting tumor aggressiveness which may predict poor prognosis. High value of SUVmax would be useful for making noninvasive diagnoses and deciding the appropriate therapeutic strategy for patients with endometrial cancer.

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