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

被引:40
作者
Leseur, Julie [1 ]
Roman-Jimenez, Geoffrey [2 ,3 ]
Devillers, Anne [4 ]
Ospina-Arango, Juan D. [2 ,5 ]
Williaume, Daniele [1 ]
Castelli, Joel [1 ,2 ]
Terve, Pierre [3 ]
Lavoue, Vincent [6 ]
Garin, Etienne [4 ]
Lejeune, Florence [4 ]
Acosta, Oscar [2 ]
De Crevoisier, Renaud [1 ,2 ]
机构
[1] Univ Rennes 1, LTSI, Ctr Eugene Marquis, Dept Radiotherapy, F-35014 Rennes, France
[2] Univ Rennes 1, LTSI, INSERM, U1099, F-35014 Rennes, France
[3] Keosys Med Imaging, St Herblain, France
[4] Ctr Eugene Marquis, Dept Nucl Med, Rennes, France
[5] Univ Nacl Colombia, Sch Stat, Bogota, Colombia
[6] CHU Anne de Bretagne Rennes, Dept Gynecol & Obstet, Rennes, France
关键词
Radiotherapy; 18F-FDG PET; Cervix cancer; Prognosis; POSITRON-EMISSION-TOMOGRAPHY; STANDARDIZED UPTAKE VALUE; FDG-PET; TUMOR VOLUME; PROGNOSTIC-SIGNIFICANCE; METABOLIC-RESPONSE; RADIATION-THERAPY; RADIOTHERAPY; CARCINOMA; MRI;
D O I
10.1016/j.radonc.2016.08.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 40 Gy (PET2). The PET analyzed parameters were: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV5 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:512 / 518
页数:7
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