Preoperative 18FFDG PET/CT predicts recurrence in patients with epithelial ovarian cancer.
- Author:
Hyun Hoon CHUNG
1
;
Hyun Woo KWON
;
Keon Wook KANG
;
Jae Weon KIM
;
Noh Hyun PARK
;
Yong Sang SONG
;
Soon Beom KANG
Author Information
- Publication Type:Original Article
- Keywords: Distribution; Epithelial ovarian cancer; Recurrence; Standardized uptake value
- MeSH: Disease-Free Survival; Humans; Mucins; Multivariate Analysis; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Recurrence; Umbilicus
- From:Journal of Gynecologic Oncology 2012;23(1):28-34
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To determine whether [18F]FDG uptake on PET/CT imaging before surgical staging has prognostic significance in patients with epithelial ovarian cancer (EOC). METHODS: Patients with EOC were imaged with integrated PET/CT before surgical staging. Hypermetabolic lesions were measured as the standardized uptake value (SUV) in primary and metastatic tumors. SUV distribution was divided into two regions at the level of umbilicus, and the impact of the ratio between above and below umbilicus (SUVlocation ratio) on progression-free survival (PFS) was examined using Cox proportional hazards regression. RESULTS: Between January 2004 and December 2009, 55 patients with EOC underwent preoperative PET/CT. The median duration of PFS was 11 months (range, 3 to 43 months), and twenty (36.4%) patients experienced recurrence. In univariate analysis, high SUVlocation ratio (p=0.002; hazard ratio [HR], 1.974; 95% confidence interval [CI], 1.286 to 3.031) was significantly associated with recurrence. Malignant mixed mullerian tumor compared with endometrioid histology was also shown to have significance. In multivariate analysis, high SUVlocation ratio (p=0.005; HR, 2.418; 95% CI, 1.1315 to 4.447) and histology (serous, mucinous, and malignant mixed mullerian tumor compared with endometrioid type) were significantly associated with recurrence. Patients were categorized into two groups according to SUVlocation ratio (<0.3934 vs. > or =0.3934), and the Kaplan-Meier survival graph showed a significant difference in PFS between the groups (p=0.0021; HR, 9.47, log-rank test). CONCLUSION: SUV distribution showed a significant association with recurrence in patients with EOC, and may be a useful predictor of recurrence.
