Tuulia Vallius1, Anniina Peter2, Annika Auranen3, Olli Carpén4, Jukka Kemppainen5, Jaakko Matomäki6, Sinikka Oksa7, Pia Roering2, Marko Seppänen5, Seija Grénman8, Johanna Hynninen8. 1. Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Finland. Electronic address: tuulia.vallius@utu.fi. 2. Department of Pathology, Turku University Hospital, University of Turku, Finland. 3. Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Finland; Department of Obstetrics and Gynecology, Tampere University Hospital, Finland. 4. Department of Pathology, Turku University Hospital, University of Turku, Finland; Auria biobank, Turku University Hospital, Finland. 5. Department of Clinical Physiology and Nuclear Medicine, Turku PET Centre, Turku University Hospital, University of Turku, Finland. 6. Department of Pediatrics, Turku University Hospital, University of Turku, Finland. 7. Department of Obstetrics and Gynecology, Satakunta Central Hospital, Finland. 8. Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Finland.
Abstract
OBJECTIVE: The aim of this study was to examine the relationship between the reduction of maximum standardized uptake values (SUVmax) in 18F-FDG-PET/CT to histopathological changes obtained with neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer (EOC). We wanted to evaluate whether 18F-FDG-PET/CT is useful for identifying patients who will not respond to NACT and would therefore benefit from second-line chemotherapy instead of interval debulking surgery (IDS). METHODS: Twenty-six primarily inoperable EOC patients treated with NACT were enrolled in this study. 18F-FDG-PET/CT imaging was performed before diagnostic laparoscopy and after three to four NACT cycles. The relationship between the decrease in omental SUVmax from before to after NACT with omental histopathological response was examined in samples taken from the corresponding anatomical sites during IDS. Patients were divided into three groups according to chemotherapy-induced histopathological changes. Serum CA125 and HE4 halftimes during NACT as well as Ki-67 antigen expression in IDS samples were determined. RESULTS: The median omental SUVmax change during NACT was -64% (range-16% to -84%), and it was associated with histopathological response (p=0.004, OR 0.9, CI 0.84-0.97). A SUVmax decrease of less than 57% identified histopathological non-responders. Progression-free survival (PFS) differed between the poor, moderate and good histopathological response groups (0.9 year vs. 1.2 years vs. 1.4 years, respectively, p=0.05). The SUVmax change was not associated with PFS. CONCLUSION: 18F-FDG-PET/CT was able to identify patients who would not respond to NACT. To obtain a histopathological response in EOC, a substantial metabolic response in 18F-FDG-PET/CT is necessary.
OBJECTIVE: The aim of this study was to examine the relationship between the reduction of maximum standardized uptake values (SUVmax) in 18F-FDG-PET/CT to histopathological changes obtained with neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer (EOC). We wanted to evaluate whether 18F-FDG-PET/CT is useful for identifying patients who will not respond to NACT and would therefore benefit from second-line chemotherapy instead of interval debulking surgery (IDS). METHODS: Twenty-six primarily inoperable EOC patients treated with NACT were enrolled in this study. 18F-FDG-PET/CT imaging was performed before diagnostic laparoscopy and after three to four NACT cycles. The relationship between the decrease in omental SUVmax from before to after NACT with omental histopathological response was examined in samples taken from the corresponding anatomical sites during IDS. Patients were divided into three groups according to chemotherapy-induced histopathological changes. Serum CA125 and HE4 halftimes during NACT as well as Ki-67 antigen expression in IDS samples were determined. RESULTS: The median omental SUVmax change during NACT was -64% (range-16% to -84%), and it was associated with histopathological response (p=0.004, OR 0.9, CI 0.84-0.97). A SUVmax decrease of less than 57% identified histopathological non-responders. Progression-free survival (PFS) differed between the poor, moderate and good histopathological response groups (0.9 year vs. 1.2 years vs. 1.4 years, respectively, p=0.05). The SUVmax change was not associated with PFS. CONCLUSION: 18F-FDG-PET/CT was able to identify patients who would not respond to NACT. To obtain a histopathological response in EOC, a substantial metabolic response in 18F-FDG-PET/CT is necessary.
Authors: Elizabeth V Nguyen; Kaisa Huhtinen; Young Ah Goo; Katja Kaipio; Noora Andersson; Ville Rantanen; Johanna Hynninen; Riitta Lahesmaa; Olli Carpen; David R Goodlett Journal: Mol Cell Proteomics Date: 2017-04-28 Impact factor: 5.911
Authors: Roberto C Delgado Bolton; Nicolas Aide; Patrick M Colletti; Annamaria Ferrero; Diana Paez; Andrea Skanjeti; Francesco Giammarile Journal: Eur J Nucl Med Mol Imaging Date: 2021-07-03 Impact factor: 9.236
Authors: Tuulia Vallius; Johanna Hynninen; Jukka Kemppainen; Victor Alves; Kari Auranen; Jaakko Matomäki; Sinikka Oksa; Johanna Virtanen; Seija Grénman; Annika Auranen; Marko Seppänen Journal: Eur J Nucl Med Mol Imaging Date: 2018-02-23 Impact factor: 9.236
Authors: Young Shin Chung; Hyun-Soo Kim; Jung-Yun Lee; Won Jun Kang; Eun Ji Nam; Sunghoon Kim; Sang Wun Kim; Young Tae Kim Journal: Cancer Res Treat Date: 2020-04-28 Impact factor: 4.679