The Prognostic Value of the Metabolic Tumor Volume in FIGO stage IA to IIB Cervical Cancer for Tumor Recurrence: Measured by F-18 FDG PET/CT

Chung

et al. 2013

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.

Section: Discussionmentioning

confidence: 99%

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

Chung

et al. 2013

“…Up to now, the clinical use of FDG PET/CT has been established in gynecological malignancies such as cervical, ovarian, and vulvar cancer. However, only a few studies [20,21] have reported the prognostic value of FDG PET/CT in gynecological malignancies. To the best of our knowledge, this is the second report regarding the prognostic value of FDG PET/CT by semiquantitatively measuring the SUVmax of primary tumors and LNs in endometrial cancer.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metabolic Activity Measured by 18F-FDG PET/CT in Patients with Advanced Endometrial Cancer

Choi

Jeong

et al. 2013

Purpose We evaluated the potential prognostic value of 18 Ffluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) in patients with stage IIIC/ IV endometrial cancer. Methods Patients with stage IIIC/IV endometrial cancer who had undergone FDG PET/CT workup for staging were enrolled. Maximum standardized uptake values (SUVmax) measured from regions of interest (ROIs) of the primary tumor (SUVt) and lymph nodes (SUVn) were correlated with overall survival (OS). The SUVn was defined as the highest SUVmax of the metastatic lymph nodes. Survival probability was assessed using the Kaplan-Meier method. Results A total of 42 patients with a median age of 55.5 years (range 32-76 years) were included. Twenty-nine percent (n =12) of patients were premenopausal and 71 % (n =30) were postmenopausal. The average SUVt was 12.9 (range 1.8-36.5), and the average SUVn was 7.3 (range 2.0-22.5). Median follow-up time was 25.9 months (range 1-84 months). Using a SUVt of 9.5 as a cutoff value, two groups with different rates were determined (P =0.026). In addition, patients with a low SUVn had significantly better OS than those with a high SUVn (P =0.003). Patients in the International Federation of Obstetrics and Gynecology (FIGO) stage IV group with SUVt≥9.5 or SUVn≥7.3 showed a significantly longer OS than the other groups.

“…MTV and TLG of 18 F-FDG PET/CT are suggested to be better indicators of whole tumor burden than SUVmax, and proved to be prognostic factors at diagnosis in a variety of malignancies. [12][13][14][15][16][17]. Moreover, these indices demonstrated the possibility of predicting chemotherapy effect in osteogenic sarcoma, not only at the end of the neoadjuvant chemotherapy [18,19], but also after the second cycle [20].…”

mentioning

confidence: 91%

Usefulness of Combined Metabolic–Volumetric Indices of 18F-FDG PET/CT for the Early Prediction of Neoadjuvant Chemotherapy Outcomes in Breast Cancer

et al. 2012

Purpose The purpose of this study was to investigate the usefulness of metabolic-volumetric indices of 18 Ffluorodeoxy-D-glucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of neoadjuvant chemotherapy outcomes in breast cancer. Methods Twenty-four patients with locally advanced breast cancer were enrolled in the study. They underwent baseline 18 F-FDG PET/CT scan and received four or six cycles of neoadjuvant chemotherapy, interim 18 F-FDG PET/CT was done after second cycle of chemotherapy. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary lesions were calculated. Reduction rates of these parameters were obtained between baseline and interim 18 F-FDG PET/ CT. Chemotherapy outcomes were assessed using tumor size reduction rate and histological grading system (Miller and Payne system). Reduction rates of SUVmax, MTV, and TLG correlated with chemotherapy outcomes. Results MTV and TLG reduction rates showed significant correlation with tumor size reduction rate (R00.68, P0 0.0004; R00.62, P00.002, respectively). However, SUVmax reduction rate showed no significant correlation. MTV and TLG reduction rates were significantly higher in responders than nonresponders, as determined by Miller and Payne system (P<0.0007, P<0.002). However, SUVmax reduction rate showed no significant difference. On ROC analysis, the area under the MTV and TLG curves was 0.886, and that of SUVmax was 0.743. Sensitivity, specificity, positive predictive value, and negative predictive value to predict histopathologic response were the same for MTV and TLG, and the values were 100 %, 85.7 %, 83.3 %, and 100 %, respectively (at the reduction rate of 93.2 % for MTV, and 95.8 % for TLG). Conclusion Changes of metabolic-volumetric indices successfully reflected the neoadjuvant chemotherapy outcomes. MTV and TLG could be robust indices in discriminating pathologic responder as SUVmax, after neoadjuvant chemotherapy.