Pre- and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer.

Abstract

PURPOSE:

To describe the evolution and to assess the predictive value of metabolic parameters with different SUV threshold segmentations calculated from two 18F-FDG-PET/CT, one prior to and the other one during concomitant chemoradiation therapy (CCRT), for locally-advanced cervical cancer (LACC).

MATERIAL AND METHODS:

53 patients treated for LACC by CCRT underwent FDG-PET/CT before treatment (PET1) and another one at 40Gy (PET2). The PET analyzed parameters were: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTVs were automatically segmented using various percentage SUVmax thresholds (30-70%) and fixed SUV thresholds (all voxels with SUV >1-20). The parameters' predictive capabilities for disease-free (DFS) and overall survival (OS) were assessed using the Harrell's C-index (c) and Cox regression model.

RESULTS:

Depending on the SUVmax threshold, the relative decreases in MTV and TLG from PET1 to PET2 were, on average, 65% (range: 63-70%) and 85% (range: 83-86%), respectively. The strongest predictive threshold segmentations were 55% SUVmax in PET1 and 32% in PET2. Significant predictors of DFS in multivariate analysis (c=0.82) were MTV1 (55% SUVmax) in PET1 and TLG2 (32% SUVmax) in PET2. MTV1 (55%) was the most significant OS predictor.

CONCLUSIONS:

MTV and TLG calculated with a threshold of 55% SUVmax and 32% SUVmax from pre- and per-treatment PET scans respectively, can be used to predict patient outcome after CCRT for LACC.

• Authors: Julie Leseur, Geoffrey Roman-Jimenez, Anne Devillers, Juan D Ospina-Arango, Daniele Williaume, Joel Castelli, Pierre Terve, Vincent Lavoue, Etienne Garin, Florence Lejeune, Oscar Acosta, Renaud De Crevoisier
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 120 Issue 3 Pg. 512-518 (09 2016) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 27569847 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Chemoradiotherapy (methods)
• Female
• Fluorodeoxyglucose F18
• Follow-Up Studies
• Glycolysis
• Humans
• Kaplan-Meier Estimate
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Positron Emission Tomography Computed Tomography (methods)
• Prognosis
• Prospective Studies
• Tumor Burden
• Uterine Cervical Neoplasms (diagnostic imaging, metabolism, pathology, therapy)