Maria Lee1, Hyunjong Lee2, Gi Jeong Cheon2, Hee Seung Kim1, Hyun Hoon Chung3, Jae-Weon Kim1, Noh-Hyun Park1, Yong Sang Song1. 1. Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 2. Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 3. Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. chhkmj@gmail.com.
Abstract
OBJECTIVES: To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). METHODS: We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative 18F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUVmax and SUVavg), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). RESULTS: Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. CONCLUSIONS: Preoperative IFH measured by 18F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. KEY POINTS: • Preoperative IFH was significantly associated with recurrence of EOC • Disease-free survival significantly differed in groups categorized by IFH • FDG-based heterogeneity could be a potential predicator of EOC recurrence before treatment.
OBJECTIVES: To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC). METHODS: We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative 18F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUVmax and SUVavg), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS). RESULTS: Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence. CONCLUSIONS: Preoperative IFH measured by 18F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment. KEY POINTS: • Preoperative IFH was significantly associated with recurrence of EOC • Disease-free survival significantly differed in groups categorized by IFH • FDG-based heterogeneity could be a potential predicator of EOC recurrence before treatment.
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