Diagnostic Accuracy of Preoperative Metabolic ¹⁸F-FDG PET/CT Parameters for Patients with Endometrial Cancer Treated with Postoperative Radiation Therapy

Abstract

Objective: This study aimed to evaluate the diagnostic accuracy of preoperative 18 F-fluorodeoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters for the prediction of risk factors and detection of lymph node metastasis (LNM) in patients with endometrial cancer. Material and Methods:This study included 26 patients with endometrioid carcinoma who underwent preoperative PET/CT and treated with adjuvant local radiotherapy. The maximum standard uptake value of the tumor (SUV max -T), SUV max of the pelvic and/or para-aortic LNs, metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) with cut-off values of 30-40% were calculated. International Federation of Gynecology and Obstetrics stages 3 and 4, highgrade disease, lymphovascular invasion (LVI), cervical involvement (CI), and myometrial invasion (MI) ≥50% were established as high-risk features. Disease-free survival and overall survival were analyzed in comparison with 18 F-FDG PET/CT parameters.Results: SUV max -T was only associated with tumor diameter (p=0.01). It was not correlated with MI, high-grade disease, CI, or LNM. With SUV max -P ≥2.81 as a cut-off value, the sensitivity, What this study adds? 18 F-FDG PET/CT is not standart diagnostic image in endometrial cancer (EC). According to our results, we found out that the metabolic parameters on 18 F-FDG PET/CT, for prediction of lymph node metastases increase diagnostic accuracy for EC.