Prognostic value of metabolic tumor volume and total lesion glycolysis from ¹⁸F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma
- Author:
Dou dou LIU
1
;
Jianfang LI
;
Xiaomao LI
;
Liangjun XIE
;
Luping QIN
;
Fangyu PENG
;
Mu hua CHENG
Author Information
- Publication Type:Original Article
- Keywords: Endometrial Carcinoma; Lymphatic Metastases; Tumor Volume; Metabolism; Risk Assessment
- MeSH: Classification; Diagnosis; Electrons; Endometrial Neoplasms; Female; Glycolysis; Humans; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Metabolism; Neoplasm Metastasis; Positron-Emission Tomography and Computed Tomography; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Tumor Burden
- From:Journal of Gynecologic Oncology 2019;30(6):e89-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
