The prognostic value of preoperative FDG-PET/CT metabolic parameters in cervical cancer patients

被引:10
作者
Bollineni V.R. [1 ,2 ,3 ]
Ytre-Hauge S. [4 ,5 ]
Gulati A. [4 ,5 ]
Halle M.K. [1 ,2 ]
Woie K. [1 ]
Salvesen Ø. [6 ]
Trovik J. [1 ,2 ]
Krakstad C. [1 ,2 ]
Haldorsen I.S. [4 ,5 ]
机构
[1] Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen
[2] Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Bergen
[3] Department of Radiology, Ziekenhuis Oost-Limburg, Campus St-Jan, Genk
[4] Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Bergen
[5] Department of Clinical Medicine, University of Bergen, Bergen
[6] Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim
来源
European Journal of Hybrid Imaging | / 2卷 / 1期
关键词
Cervical cancer; DW-MRI; FDG-PET/CT; MTV; TLG;
D O I
10.1186/s41824-018-0042-2
中图分类号
学科分类号
摘要
Background: To explore quantitative metabolic and microstructural primary tumour parameters at pretreatment FDG-PET/CT and diffusion-weighted-magnetic resonance imaging (DW-MRI) in relation to clinical FIGO stage and outcome in uterine cervical cancer patients. Methods: Fifty three patients with histopathologically verified cervical carcinoma with clinical FIGO stage IB1-IVA were subjected to FDG-PET/CT and subgroup also DW-MRI (n = 30) prior to treatment. Measurements from the FDG-PET/CT comprised lesion maximum-standardised uptake value (SUVmax), total lesion glycolysis (TLG) and metabolic tumour volume (MTV). In MR images longest-tumour-diameter (MRI-LD), tumour volume (MRI-TV) and mean tumour apparent-diffusion-coefficient (ADCmean) value were measured. FDG-PET/CT parameters were explored in relation to clinical prognostic factors at diagnosis and progression/recurrence free survival, and compared with the MRI parameters. Results: The metabolic tumour parameters TLG and MTV were highly positively correlated to MRI-LD and MRI-TV (rs = 072–0.82; p < 0.001 for all), whereas tumour SUVmax was only moderately correlated to MRI-LD (rs = 0.29; p ≤ 0.04) and MRI-TV (rs = 0.36; p ≤ 0.01). High tumour TLG, MTV, MRI-LD and MRI-TV predicted advanced FIGO stage, whereas high tumour SUVmax did not. No significant correlations were observed between tumour ADCmean and the other imaging parameters or FIGO stage. High primary tumour MTV (≥56.7 mL), high TLG (≥412 g) and large MRI-TV (≥36 mL) predicted reduced progression/recurrence free survival yielding corresponding hazard ratios [HR] of 7.8 (P = 0.002), 6.9 (P = 0.004) and 4.6 (P = 0.022), respectively. Also advanced FIGO stage (≥IIIA) was associated with reduced progression/recurrence free survival with HR of 6.9 (P = 0.004). In multivariable analysis, advanced FIGO stage (≥IIIA) and high MTV (≥56.7 mL) were independent prognostic factors with adjusted HRs of 5.5 (P = 0.020) and 7.8 (P = 0.025), respectively. Conclusion: High MTV at pre-treatment FDG-PET/CT and high clinical FIGO stage independently predict reduced progression/recurrence free survival in cervical cancer patients. © 2018, The Author(s).
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共 32 条
[1]  
Akkas B.E., Demirel B.B., Dizman A., Vural G.U., Do clinical characteristics and metabolic markers detected on positron emission tomography/computerized tomography associate with persistent disease in patients with in-operable cervical cancer?, Ann Nucl Med, 27, 8, pp. 756-763, (2013)
[2]  
Balleyguier C., Sala E., Da Cunha T., Et al., Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology, Eur Radiol, 21, 5, pp. 1102-1110, (2011)
[3]  
Beiderwellen K., Huebner M., Heusch P., Et al., Whole-body [18F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results, Eur Radiol, 24, 8, pp. 2023-2030, (2014)
[4]  
Benedet J.L., Bender H., Jones H., Ngan H.Y., Pecorelli S., FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO committee on gynecologic oncology, Int J Gynaecol Obstet, 70, 2, pp. 209-262, (2000)
[5]  
Boellaard R., Delgado-Bolton R., Oyen W.J.G., Et al., FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0, Eur J Nucl Med Mol Imaging, 42, 2, pp. 328-354, (2015)
[6]  
Bollineni V.R., Kramer G., Liu Y., Melidis C., deSouza N.M., A literature review of the association between diffusion-weighted MRI derived apparent diffusion coefficient and tumour aggressiveness in pelvic cancer, Cancer Treat Rev, 41, 6, pp. 496-502, (2015)
[7]  
Brandmaier P., Purz S., Bremicker K., Hockel M., Barthel H., Kluge R., Kahn T., Sabri O., Stumpp P., Simultaneous [18F]FDG-PET/MRI: Correlation of Apparent Diffusion Coefficient (ADC) and Standardized Uptake Value (SUV) in Primary and Recurrent Cervical Cancer, PLOS ONE, 10, 11, (2015)
[8]  
Choi H.J., Kim S.H., Seo S.-S., Et al., MRI for pretreatment lymph node staging in uterine cervical Cancer, Am J Roentgenol, 187, 5, pp. W538-W543, (2006)
[9]  
Chong G.O., Jeong S.Y., Park S.-H., Et al., Comparison of the prognostic value of F-18 pet metabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical Cancer who are treated with concurrent Chemoradiotherapy, PLoS One, 10, 9, (2015)
[10]  
Chung H.H., Kim J.W., Han K.H., Et al., Prognostic value of metabolic tumor volume measured by FDG-PET/CT in patients with cervical cancer, Gynecol Oncol, 120, 2, pp. 270-274, (2011)