Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

Abstract

BACKGROUND: This study aimed to evaluate the variation in cervical cancer glucose metabolism for different tumor histologies and levels of differentiation, as measured by the uptake of 18F‐fluorodeoxyglucose (FDG) by positron emission tomography (PET). METHODS: The study population consisted of 240 patients with International Federation of Gynecology and Obstetrics stages Ib1 through IVb cervical cancer, who underwent a pretreatment FDG‐PET. Tumor histology included 221 squamous cell (SC), 4 adenosquamous (AS), and 15 adenocarcinoma (AC) tumors. There were 14 well, 145 moderately, and 81 poorly differentiated tumors. The stage distribution was as follows: 70 stage I tumors (9 AC, 2 AS, and 59 SC), 102 stage II tumors (3 AC, 1 AS, and 98 SC), 64 stage III tumors (3 AC, 1 AS, and 60 SC), and 4 stage IV tumors (4 SC). From the FDG‐PET, maximal standardized uptake value (SUVmax) was determined. The variation in SUVmax was analyzed for differences based on tumor histology and differentiation. RESULTS: For all patients, the mean SUVmax was 11.62 (range, 2.50‐50.39). The mean SUVmax by histology was as follows: SC, 11.91 (range, 2.50‐50.39); AS, 8.85 (range, 6.53‐11.26); and AC, 8.05 (range, 2.83‐13.92). Squamous versus nonsquamous tumors demonstrated a significant difference in SUVmax (P = .0153). SUVmax and tumor volume were not found to be correlated (R2 = 0.013). The mean SUVmax was 8.58 for well‐differentiated, 11.56 for moderately differentiated, and 12.23 for poorly differentiated tumors. The mean SUVmax was significantly different for well‒differentiated versus poorly differentiated cervical tumors (P = .0474). CONCLUSIONS: Cervical tumor FDG uptake varied by histology and differentiation. SC tumors demonstrated a significantly higher SUVmax compared with nonsquamous cell tumors, and poorly differentiated tumors also had a higher SUVmax. Cancer 2009. © 2009 American Cancer Society.

Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

“…Furthermore, the present study illustrates that poorlydifferentiated tumors exhibit higher SUVs and lower ADCmin values in comparison to well-and moderately differentiated cervical tumor lesions. Investigating variations in glucose metabolism of cervical cancers in dependence of differentiation levels, Kidd et al published similar results, showing a significant higher FDG uptake in poorly-differentiated compared to welldifferentiated tumors [30]. Our results regarding the ADC values go in line with a recent publication, in demonstrating the correlation between lower ADC values and poorly differentiated tumors compared to those that were well-or moderately differentiated [31].…”

PET in uterine malignancies

“…In uterine cancer different authors reported an independent correlation between the cancer SUVmax and: the lymph node status, the disease response to chemo/radio therapy, the frequency of pelvic recurrence, the disease free and the overall survival [12,[17][18][19][20]. In a study on 240 patients, Kidd et al [21] confirmed the correlation between the SUVmax at the staging and the presence of lymph node metastases. Moreover, Lee and colleagues [22] observed a good correlation between SUVmax and DFS in early stages of cervical cancer.…”

Standardized Uptake Value on ¹⁸F-FDG PET/CT as a Prognostic Factor for Survival of Women with Malignant Uterine Tumors: A Meta-Analysis

“…Finally, heterogeneity of the selected trials was present. It mostly originated in different histological subtype, tumor differentiation, stage of disease, study design, sample size, patient populations, methodology and cut-off SUV max [41,42]. Additionally, the smaller number of studies for each risk factor made it harder to explore the heterogeneity of this meta-analysis for OS.…”