Prognostic Value of Preoperative Metabolic Tumor Volume and Total Lesion Glycolysis in Patients with Epithelial Ovarian Cancer

Chung, Hyun Hoon; Kwon, Ho Jang; Kang, Keon Wook; Park, Noh-Hyun; Song, Yong Sang; Chung, June-Key; Kang, Soon‐Beom; Kim, Jae Weon

doi:10.1245/s10434-011-2153-x

Cited by 137 publications

(99 citation statements)

References 27 publications

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“…In accordance with our results, we found that the inclusion of PET/CT in the management of patients with recurrent ovary cancer had an impact on the decision making in 42% of subjects. As reported in the literature, the change in management of patients with OC who have undergone FDG PET/ CT ranges between 25% and 58% (10,(15)(16)(17)(18). OC can disseminate to the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Evangelista

Palma

Gregianin

et al. 2015

J Turkish German Gynecol Assoc

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Ovarian cancer (OC) accounts for approximately 3% of cancers in women; 125,000 women are estimated to die of the disease each year. OC is curable when identified at an early stage. However, because there is no effective screening test for this tumor and its symptoms are vague, approximately 70-80% of patients are diagnosed at an advanced stage of the disease (stage III and IV, in accordance with the International Federation of Gynecology and Obstetrics (FIGO)); this means that the survival rate is low (1). More than 70% of stage III-IV patients have a relapse of the disease, and even in stage I or II, the relapse rate is 20-25% (2). The serial evaluation of serum cancer antigen-125 (CA125) can be useful to non-invasively detect the recurrence of disease because an elevation in CA125 levels can determine the presence of disease with a high accuracy of 79% to 95%, thus preceding a clinically apparent recurrence by 3 to 6 months (3, 4). However, normal CA125 levels cannot exclude the presence of recurrent Objective: We evaluated the efficacy of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in recurrent disease, response to therapy, and long-term follow-up of ovarian cancer (OC) patients in relation to cancer antigen-125 (CA125) levels and the prognostic meaning of this modality in this subset of subjects. Material and Methods:Between 2005 and 2015, we retrospectively evaluated 125 patients affected by OC who underwent FDG PET/CT imaging at our institution. The indications for PET/CT were recurrence of disease in 78 patients, therapy response assessment in 29, and follow-up in 18. The results of FDG PET/CT were compared with those of histopathology and clinical and radiological progression during follow-up for at least 6 months. The median long-term follow-up was 33 months. The diagnostic accuracies for the different clinical settings were evaluated. The relationships among global survival (GS), FDG PET/CT results, and CA125 levels were evaluated by both Kaplan-Meier and Cox regression analysis.Results: CA125 results were positive (>35 UI/mL) in 62 patients and negative in 63 (49% vs. 51%). The sensitivity and specificity of CA125 were 72% and 91%, respectively. PET/CT imaging showed a sensitivity of 98.6% and a specificity of 77.8% for the assessment of recurrent disease, and a sensitivity of 72.7% and a specificity of 88.9% for therapy evaluation. Meanwhile, in 18 patients evaluated during follow-up, the specificity was 82.3%. GS was significantly higher in case of negative CA125 values at the time of FDG PET/CT, of a negative PET/CT scan and when no evidence of peritoneum recurrence and distant metastases was determined by PET. Multivariate regression analysis showed that only age and peritoneum recurrence as determined by PET were identified as independent predictors of poor prognosis. Conclusion:Metabolic imaging with FDG PET/CT proved useful in patients where OC recurrence was suspected, even when the value of tumor marker CA125 was in a normal range. A positive PET/CT ...

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Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Evangelista

Palma

Gregianin

et al. 2015

J Turkish German Gynecol Assoc

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“…It was suggested that GLUT-1 expression might be an independent prognostic factor in colon cancer [12]. As for malignant ovarian tumors, potential roles of GLUT-1 expression in predicting prognosis remain unclear, but an article recently published by Chung et al provides a clue to this matter [18]. They reported that the preoperative metabolic tumor burden and its distribution measured by SUV values could predict recurrence in patients with epithelial ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Borderline Ovarian Tumors from Stage I Malignant Ovarian Tumors using FDG PET/CT

Kim

Chung

et al. 2013

Nucl Med Mol Imaging

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Purpose Borderline ovarian tumors (BOTs) are more common in young women of reproductive age, and exhibit a better prognosis than malignant ovarian tumors (MOTs). Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were compared in their ability to differentiate BOTs from stage I MOTs. Methods Among 173 patients who had preoperative FDG PET/CT due to ovarian neoplasms between November 2006 and March 2009, there were 13 patients with BOTs or stage I MOTs. For differential diagnosis of the two tumors, cancer antigen-125 (CA-125) level, the longest diameter of tumors, metabolic indices including maximum standardized uptake value (SUV max ), and volumetric indices including metabolic tumor volume (MTV) were compared, respectively. Results The BOT group (n=7) was comprised of five mucinous and two serous tumors, and the MOT group (n=6) was comprised of three endometrioid, two clear cell and one mucinous tumors. Among the comparisons between two groups, SUV max of the BOT group was significantly lower than that of the MOT group (2.9±1.5 vs. 6.6±2.9, p=0. 0223); otherwise, no significant difference was found in age, CA-125, diameter, or MTV. By receiver-operating characteristic curve analysis, SUV max of 3.7 was the best cutoff value to differentiate BOTs from stage I MOTs, with a sensitivity of 83.3 % and specificity of 85.7, and the area under curve of 0.893 (p=0.0001, 95 % CI: 0.601∼0.993). Conclusions We demonstrated that SUV max could distinguish BOTs from stage I MOTs, with a high sensitivity and specificity. Metabolic indices determined by FDG PET/CT were more suitable than volumetric indices for differential diagnosis of the two tumors.

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“…1a-c). TLG was calculated by multiplying the mean SUV (SUVmean) of the primary tumor by metabolic volume of the tumor [8]. The SUVmax, MTV and TLG of primary lung lesions were recorded as SUVmax-lung, MTV-lung, and TLG-lung, respectively.…”

Section: Assessment Of Mtv Tlg and Suvmax Of Primary Lung Lesionmentioning

confidence: 99%

“…Standardized uptake value (SUV)-based PET parameter can predict therapeutic outcome and overall survival in many types of malignancies [6][7][8][9][10][11][12]. Recently, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported as additional diagnostic and prognostic imaging biomarkers for maximum SUV (SUVmax) [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

Yoo

Kim

Chong

et al. 2012

Nucl Med Mol Imaging

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Purpose This study aimed to further stratify prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Materials and MethodsThe subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F-18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were measured by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival curves were used for evaluation of progression-free survival (PFS). The univariate and multivariate Cox proportional hazards models were used to select the significant prognostic factors. Results Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV-lung and TLG-lung) were significant factors for prediction of PFS (P<0.001, P00.038, respectively). Patients showing lower values of MTV-lung and TLG-lung than the cutoff values had significantly longer mean PFS than those with higher values. Hazard ratios (95 % confidence interval) of MTV-lung and

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Prognostic Value of Preoperative Metabolic Tumor Volume and Total Lesion Glycolysis in Patients with Epithelial Ovarian Cancer

Abstract: Pretreatment metabolic parameters such as MTV and TLG showed statistically significant association with recurrence in patients with EOC. These values can be useful quantitative criteria for disease prognostication in patients with EOC before treatment.

Cited by 137 publications

References 27 publications

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Diagnostic and prognostic evaluation of fluorodeoxyglucose positron emission tomography/computed tomography and its correlation with serum cancer antigen-125 (CA125) in a large cohort of ovarian cancer patients

Differential Diagnosis of Borderline Ovarian Tumors from Stage I Malignant Ovarian Tumors using FDG PET/CT

Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

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