Pre-Treatment [F-18]FDG-PET SUVmax as a Prognostic and Radiogenomic Marker in Cervical Cancer

Floberg, John M.; Zhang, J.; DeWees, T.A.; Markovina, Stephanie; Grigsby, Perry W.; Schwarz, Julie K.

doi:10.1016/j.ijrobp.2018.06.218

Cited by 3 publications

(3 citation statements)

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“…In addition, a recent study found that high SUV max is associated with overexpression of inflammatory genes such as those involved in JAK/ STAT3 signaling. 22 This is a complex issue that might involve multiple factors, and additional research is needed to investigate the cellular or biologic mechanism leading to increased SUV max and SCC-ag.…”

Section: Discussionmentioning

confidence: 99%

Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Shou

Yoshioka

Yuan

et al. 2020

Intl J Gynecology & Obste

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Objective To evaluate the association of pretreatment maximum standardized 18F‐fluorodeoxyglucose uptake value (SUVmax) of cervix and serum squamous cell carcinoma antigen (SCC‐ag) with FIGO2018 stage and prognosis among women with Stage IIB–IVB squamous cervical cancer. Methods Retrospective study of 116 women with FIGO2018 Stage IIB–IVB cervical cancer treated in Hangzhou, China, 2013–2015. The relationship between pretreatment SUVmax or SCC‐ag and prognostic factors was evaluated by univariate and multivariate analyses. Results Women were stratified by mean SUVmax and mean SCC‐ag. There was a significant difference between low (<12.9) and high (≥12.9) SUVmax groups in menopause (P = 0.004), FIGO2018 stage (P = 0.015), and survival rate (P < 0.001). The low group had better overall and progress‐free survival by Kaplan–Meier evaluation (both P = 0.022). High SCC‐ag (≥14.6 ng/mL) was associated with FIGO2018 stage (P = 0.038) and distant metastasis (P = 0.011). There was a significant correlation between SUVmax and serum SCC‐ag (P = 0.026). In multivariate Cox regression analyses, FIGO2018 stage (P = 0.019) and SUVmax of cervix (P = 0.015) were independent predictors of poor outcome in squamous cervical cancer. Conclusion Both SUVmax of cervix and SCC‐ag were associated with FIGO2018 stage in squamous cervical cancer. Pretreatment high SUVmax of cervix and advanced FIGO2018 stage might indicate a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Shou

Yoshioka

Yuan

et al. 2020

Intl J Gynecology & Obste

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“…In general, fast growing tumors with high cellularity, such as squamous cell carcinomas, have higher glucose metabolism than mucinous adenocarcinomas 9 12. Inflammatory cells drawn to the tumor microenvironment have also been associated with increased FDG uptake 13 14…”

Section: Discussionmentioning

confidence: 99%

Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with ¹⁸F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer

Lin

Wright

Dehdashti³

et al. 2019

Int J Gynecol Cancer

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Objective18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) detection of metastatic nodal disease is useful for guiding cervical cancer treatment but the impact of tumor histology is unknown. This study reports the detection of FDG avid pelvic and para-aortic lymph nodes in patients with early stage cervical cancer with squamous carcinoma and adenocarcinoma tumor histology.MethodsPatients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-2 cervical cancer who underwent pre-surgical FDG-PET between March 1999 and February 2018 were identified in a tertiary academic center database. All patients had radical hysterectomy with pelvic and para-aortic lymph node dissection. Detection of pelvic and para-aortic lymph nodes by FDG-PET versus surgical dissection was compared. FDG-PET sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined and stratified by tumor histology.ResultsWe identified 212 patients with early stage cervical cancer (84% FIGO IB1, 16% IB2) who underwent pre-surgical FDG-PET; 137 (65%) patients had squamous carcinoma and 75 (35%) patients had adenocarcinoma. PET/computed tomography was performed in 189 (89%) patients and 23 (11%) had PET only. Surgical dissection revealed positive pelvic and para-aortic lymph nodes in 25% and 3.3% of patients, respectively. For squamous carcinoma, sensitivity, specificity, PPV, and NPV of FDG-PET for pelvic nodal metastasis were 44%, 99%, 95%, and 78%, respectively. For adenocarcinoma, the corresponding results for pelvic nodal metastasis were 25%, 99%, 67%, and 92%, respectively. The overall values for sensitivity, specificity, PPV, and NPV of FDG-PET for para-aortic nodal metastasis were 29%, 99%, 67%, and 98%, respectively.DiscussionPelvic nodal metastasis was less likely to be detected by FDG-PET in patients with early stage adenocarcinoma than with squamous carcinoma.

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“…A common parameter is the maximum standardized uptake value (SUVmax), the highest rate of FDG uptake in the tumor indicating metabolic tumor activity. Quantitative FDG-PET parameters, and in particular, SUVmax, have been shown to be potentially prognostic in several cancers, both in primary and recurrence, pre-treatment and post neoadjuvant therapy, correlating with tumor growth, worse survival, poor prognosis, advanced stage, and worse course of disease [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. SUVmax correlates with worse outcome and stage of the disease in primary EwS [ 36 , 37 , 38 , 39 , 40 , 41 ] while studied less in recurrence.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Transcriptomics and FDG-PET SUVmax Indicates Reciprocal Expression of Stemness-Related Transcription Factor and Neuropeptide Signaling Pathways in Glucose Metabolism of Ewing Sarcoma

Prexler

Knape

Erlewein-Schweizer

et al. 2022

Cancers

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Background: In Ewing sarcoma (EwS), long-term treatment effects and poor survival rates for relapsed or metastatic cases require individualization of therapy and the discovery of new treatment methods. Tumor glucose metabolic activity varies significantly between patients, and FDG-PET signals have been proposed as prognostic factors. However, the biological basis for the generally elevated but variable glucose metabolism in EwS is not well understood. Methods: We retrospectively included 19 EwS samples (17 patients). Affymetrix gene expression was correlated with maximal standardized uptake value (SUVmax) using machine learning, linear regression modelling, and gene set enrichment analyses for functional annotation. Results: Expression of five genes correlated (MYBL2, ELOVL2, NETO2) or anticorrelated (FAXDC2, PLSCR4) significantly with SUVmax (adjusted p-value≤0.05). Additionally, we identified 23 genes with large SUVmax effect size, which were significantly enriched for “neuropeptide Y receptor activity (GO:0004983)” (adjusted p-value = 0.0007). The expression of the members of this signaling pathway (NPY, NPY1R, NPY5R) anticorrelated with SUVmax. In contrast, three transcription factors associated with maintaining stemness displayed enrichment of their target genes with higher SUVmax: RNF2, E2F family, and TCF3. Conclusion: Our large-scale analysis examined comprehensively the correlations between transcriptomics and tumor glucose utilization. Based on our findings, we hypothesize that stemness may be associated with increased glucose uptake, whereas neuroectodermal differentiation may anticorrelate with glucose uptake.

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Pre-Treatment [F-18]FDG-PET SUVmax as a Prognostic and Radiogenomic Marker in Cervical Cancer

Cited by 3 publications

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Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with ¹⁸F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer

Correlation of Transcriptomics and FDG-PET SUVmax Indicates Reciprocal Expression of Stemness-Related Transcription Factor and Neuropeptide Signaling Pathways in Glucose Metabolism of Ewing Sarcoma

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Pre-Treatment [F-18]FDG-PET SUVmax as a Prognostic and Radiogenomic Marker in Cervical Cancer

Cited by 3 publications

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Association of pretreatment SUVmax of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Association of pretreatment SUVmax of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with 18F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer

Correlation of Transcriptomics and FDG-PET SUVmax Indicates Reciprocal Expression of Stemness-Related Transcription Factor and Neuropeptide Signaling Pathways in Glucose Metabolism of Ewing Sarcoma

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Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Association of pretreatment SUV_max of cervix and SCC‐antigen with FIGO2018 stage in Stage IIB–IVB squamous cervical cancer and relationship to prognosis

Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with ¹⁸F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer