Prognostic value of (18)F-FDG PET/CT volumetric parameters in recurrent epithelial ovarian cancer

Rev Esp Med Nucl Imagen Mol. 2016 Mar-Apr;35(2):88-95. doi: 10.1016/j.remn.2015.08.005. Epub 2015 Nov 2.

Abstract

Objective: Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from (18)F-FDG PET/CT are emerging prognostic biomarkers in various solid neoplasms. These volumetric parameters and the SUVmax have shown to be useful criteria for disease prognostication in preoperative and post-treatment epithelial ovarian cancer (EOC) patients. The purpose of this study was to evaluate the utility of (18)F-FDG PET/CT measurements to predict survival in patients with recurrent EOC.

Material and methods: Twenty-six patients with EOC who underwent a total of 31 (18)F-FDG PET/CT studies for suspected recurrence were retrospectively included. SUVmax and volumetric parameters whole-body MTV (wbMTV) and whole-body TLG (wbTLG) with a threshold of 40% and 50% of the SUVmax were obtained. Correlation between PET parameters and progression-free survival (PFS) and the survival analysis of prognostic factors were calculated.

Results: Serous cancer was the most common histological subtype (76.9%). The median PFS was 12.5 months (range 10.7-20.6 months). Volumetric parameters showed moderate inverse correlation with PFS but there was no significant correlation in the case of SUVmax. The correlation was stronger for first recurrences. By Kaplan-Meier analysis and log-rank test, wbMTV 40%, wbMTV 50% and wbTLG 50% correlated with PFS. However, SUVmax and wbTLG 40% were not statistically significant predictors for PFS.

Conclusion: Volumetric parameters wbMTV and wbTLG 50% measured by (18)F-FDG PET/CT appear to be useful prognostic predictors of outcome and may provide valuable information to individualize treatment strategies in patients with recurrent EOC.

Keywords: (18)F-FDG PET/CT; (18)F-FDG PET/TC; Cáncer epitelial de ovario recurrente; Glucólisis de lesión total; Intervalo libre de progresión; Metabolic tumour volume; Progression-free survival; Recurrent epithelial ovarian cancer; Total lesion glycolysis; Volumen tumoral metabólico.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Multimodal Imaging
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Ovarian Neoplasms / diagnostic imaging*
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Positron Emission Tomography Computed Tomography*
  • Positron-Emission Tomography
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Tumor Burden