Evaluation of patients with advanced epithelial ovarian cancer before primary treatment: correlation between tumour burden assessed by [18F]FDG PET/CT volumetric parameters and tumour markers HE4 and CA125

Glickman, Ariel; Paredes, Pilar; Carreras-Dieguez, Núria; Niñerola‐Baizán, Aida; Gaba, Lydia; Pahisa, Jaume; Fusté, Pere; Pino, Marta del; Díaz-Feijoó, Berta; González-Bosquet, Eduardo; Agustí, Núria; Sánchez-Izquierdo, N.; Fuster, David; Perissinotti, Andrés; Romero, Inmaculada; Fernández-Galán, Esther; Carrasco, Josep Lluís; Gil-Ibáñez, Blanca; Torné, Aureli

doi:10.1007/s00330-021-08305-x

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…The study of Kwon et al 26 revealed that a high NLR (>2.3) and a low LMR were significantly correlated with low 5‐year progression‐free survival (PFS) and overall survival (OS) rates in patients with ovarian clear cell cancer. Glickman et al 27 found that both preoperative HE4 and CA125 were correlated with MTV.…”

Section: Discussionmentioning

confidence: 99%

Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers

Wang

Liu²,

Pang

et al. 2022

Acta Obstet Gynecol Scand

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Introduction: Complete resection after debulking surgery is strongly associated with prolonged survival for advanced serous ovarian cancer (ASOC). Though positron emission tomography/computed tomography (PET/CT) is more advantageous than computed tomorgraphy (CT) for detecting metastases, studies on the PET/CT prediction model for incomplete resection for ovarian cancer are insufficient. We analyzed and compared the predictive value of preoperative PET/CT score, CT score, metabolic parameters, tumor markers and hematological markers for incomplete resection after debulking surgery for ASOC. Material and methods:A total of 62 ASOC patients who underwent preoperative [ 18 F]FDG PET/CT and debulking surgery were retrospectively analyzed. PET/CT and CT scores were based on the Suidan model. The predictive value of PET/CT score, CT score, the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), lymphocyteto-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR) and neutrophil-tolymphocyte ratio (NLR) for incomplete resection were analyzed and compared. Results: Preoperative PET/CT score had the highest predictive value for incomplete resection in primary debulking surgery group (sensitivity: 65.0%, specificity: 88.9%, area under the ROC curve (AUC): 0.847, p < 0.001), however, in secondary debulking surgery group, preoperative PET/CT score and CT score had the same and highest predictive value for incomplete resection (sensitivity: 80.0%, specificity: 94.7%, AUC: 0.853, p = 0.017), compared with preoperative metabolic parameters SUVmax and MTV, tumor markers HE4 and CA125, and hematological markers LMR, PLR and NLR. Preoperative PET/CT score ≥ 3 (Suidan model) and preoperative PET/CT score ≥ 2 predicted a high risk of incomplete resection after primary and secondary debulking We retrospectively analyzed patients with ASOC at our hospital from July 1, 2015 to January 31, 2022 (stages III-IV according to the International Federation of Gynecology and Obstetrics [FIGO]surgeries, respectively. There was no statistical difference between primary and secondary debulking surgery groups in predictive value of PET/CT score for incomplete resection (p = 0.971). There were significant differences between PET/CT scores and CT scores in primary debulking surgery group and no significant differences in secondary debulking surgery group.Conclusions: A high PET/CT score predicted a high risk of incomplete resection. The preoperative PET/CT score had an identical predictive value in primary and secondary debulking surgery groups. PET/CT score was more accurate in the detection of metastases than CT score was.

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Section: Discussionmentioning

confidence: 99%

Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers

Wang

Liu²,

Pang

et al. 2022

Acta Obstet Gynecol Scand

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“…Both tumor markers and 18 F-FDG PET/CT can provide information about tumor burden, and the assessment of tumor burden is crucial for optimal patient management in clinical practice. However, there is little information in the literature regarding whether increases in serum tumor markers are connected to the spread of specific types of tumors ( 26 ). Our study showed a weak but statistically significant correlation between serum HE4 levels and systemic disease as assessed by WBMTV and WBTLG in the posttreatment PET-P patient cohort.…”

Section: Discussionmentioning

confidence: 99%

Predicting epithelial ovarian cancer prognosis: correlation of posttreatment 18F-fluorodeoxyglucose positron emission tomography-computed tomography metabolic parameters, serum carbohydrate antigen, and human epididymis protein levels with overall survival

Yang,

Li,

Liang

et al. 2024

Quant Imaging Med Surg

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Background Identifying reliable prognostic indicators can aid in improving patient care. The aim of this study was to establish the association of 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG PET/CT) whole-body metabolic parameters, serum carbohydrate antigen 125 (CA125), and human epididymis protein 4 (HE4) with overall survival (OS) in patients with epithelial ovarian cancer (EOC) after surgery combined with platinum-based chemotherapy. Methods From May 2014 to May 2019, a total of 79 patients with EOC who underwent posttreatment 18 F-FDG PET/CT in the First Affiliated Hospital of Chongqing Medical University were included. Clinical data and laboratory indicators were obtained. The whole-body maximum standardized uptake value (WBSUVmax), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG) were measured and calculated on 18 F-FDG PET/CT. The follow-up was conducted until February 2023, and the endpoint was death from any cause. Pearson correlation analysis, Kaplan-Meier, and Cox proportional regression were used in this study. Results The PET-positive (PET-P) patients had significantly decreased OS based on either Kaplan-Meier survival analysis (P<0.001) or univariate Cox regression analysis [hazard ratio (HR) =40.177, 95% confidence interval (CI): 2.690–600.134; P=0.007]. “Ln” is a logarithmic transformation with a base of “e” (natural logarithm). LnWBMTV, lnWBTLG, and therapy after PET were independent predictors of OS in a cohort of 63 PET-P patients. The difference in OS between groups sorted by the median WBMTV (4.16; P<0.001) and WBTLG (14.71; P<0.001) was statistically significant. There were statistically significant differences in CA125 and HE4 levels between patients in the PET-P and PET-negative (PET-N) groups (P<0.001). In the PET-P patient cohort, serum HE4 levels were substantially correlated with WBMTV and WBTLG. Kaplan-Meier survival analysis suggested a reduction in OS after treatment in patients with EOC positive for CA125, HE4, and PET (P<0.001). Conclusions Post-PET/CT treatment strategy, WBMTV, and WBTLG demonstrated significant prognostic utility in predicting posttreatment OS in patients with EOC. Patients who tested positive for both tumor markers CA125 and HE4 and had a positive PET scan demonstrated a significantly poorer prognosis in terms of posttreatment OS.

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“…There has been research about serum tumor markers and PET/CT metabolic features which are biomarkers in the prediction and evaluation of cancer. Ariel et al found that MTV and TLG of the whole body in advanced epithelial ovarian cancer signi cantly were correlated with serum CA125 and HE4 making sense to cancer strati cation (11). Shuang Ye et al found TLG60 was an independent negative predictor of overall survival for ovarian clear cell carcinoma (12).…”

Section: Discussionmentioning

confidence: 99%

Artificial intelligence algorithm for preoperative prediction of FIGO stage in ovarian cancer based on clinical features integrated 18F-FDG PET/CT metabolic and radiomics features

Xu,

Zhu,

et al. 2024

Preprint

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Purpose The FIGO stage is critical to guiding the treatments of OC. We tried to develop a model to predict the FIGO stage of OC through machine learning algorithms with patients’ pretreatment clinical, PET/CT metabolic, and radiomics features. (2) Methods: We enrolled OC patients who underwent PET/CT scans and divided them into two cohorts according to their FIGO stage. Then we manually delineated the VOI and calculated PET metabolic features. Other radiomics PET/CT features were extracted by Python. We developed 11 prediction models to predict stages based on four groups of features and conducted three experiments to verify the meaning of PET/CT features. We also redesigned experiments to demonstrate the stage prediction performance in OCCC and MCOC. (3) Results: 183 OC patients were enrolled in this study, and we obtained 137 features from four groups of data. The best model was an adaptive ensemble with an AUC value of 0.819. Our proposed models presented the best result of 0.808 in terms of AUC in OCCC and MCOC patients’ groups. (4) Conclusion: Through AI algorithms, the PET/CT metabolic and radiomics features combined with clinical features could improve the accuracy of staging prediction.

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Evaluation of patients with advanced epithelial ovarian cancer before primary treatment: correlation between tumour burden assessed by [18F]FDG PET/CT volumetric parameters and tumour markers HE4 and CA125

Cited by 9 publications

References 31 publications

Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers

Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers

Predicting epithelial ovarian cancer prognosis: correlation of posttreatment 18F-fluorodeoxyglucose positron emission tomography-computed tomography metabolic parameters, serum carbohydrate antigen, and human epididymis protein levels with overall survival

Artificial intelligence algorithm for preoperative prediction of FIGO stage in ovarian cancer based on clinical features integrated 18F-FDG PET/CT metabolic and radiomics features

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