Volume-based quantitative FDG PET/CT metrics and their association with optimal debulking and progression-free survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery
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Our aim was to evaluate the associations between quantitative 18 F-fluorodeoxyglucose positron-emission tomography (FDG-PET) uptake metrics, optimal debulking (OD) and progression-free survival (PFS) in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery.
Fifty-five patients with recurrent ovarian cancer underwent FDG-PET/CT within 90 days prior to surgery. Standardized uptake values (SUVmax), metabolically active tumour volumes (MTV), and total lesion glycolysis (TLG) were measured on PET. Exact logistic regression, Kaplan-Meier curves and the log-rank test were used to assess associations between imaging metrics, OD and PFS.
MTV (p = 0.0025) and TLG (p = 0.0043) were associated with OD; however, there was no significant association between SUVmax and debulking status (p = 0.83). Patients with an MTV above 7.52 mL and/or a TLG above 35.94 g had significantly shorter PFS (p = 0.0191 for MTV and p = 0.0069 for TLG). SUVmax was not significantly related to PFS (p = 0.10). PFS estimates at 3.5 years after surgery were 0.42 for patients with an MTV ≤ 7.52 mL and 0.19 for patients with an MTV > 7.52 mL; 0.46 for patients with a TLG ≤ 35.94 g and 0.15 for patients with a TLG > 35.94 g.
FDG-PET metrics that reflect metabolic tumour burden are associated with optimal secondary cytoreductive surgery and progression-free survival in patients with recurrent ovarian cancer.
• Both TLG and MTV were associated with optimal tumour debulking.
• There was no significant association between SUVmax and tumour debulking status.
• Patients with higher MTV and/or TLG had significantly shorter PFS.
• SUVmax was not significantly related to PFS.
KeywordsOvarian cancer PET/CT Imaging Recurrence Secondary cytoreduction
Metabolically active tumour volume
Positron emission tomography
Standardized uptake value
Total lesion glycolysis
The scientific guarantor of this publication is Evis Sala. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This project was supported in part by NIH grant P30 CA008748. HA Vargas is supported by the Kaleidoscope of Hope Foundation. One of the authors (Debra A Goldman) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Some study subjects or cohorts have been previously reported in: Sala, E., et al., (2010) Recurrent ovarian cancer: use of contrast-enhanced CT and PET/CT to accurately localize tumor recurrence and to predict patients' survival. Radiology 257(1):125-34. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
- 5.Harter P, Sehouli J, Reuss A et al (2011) Prospective validation study of a predictive score for operability of recurrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. Int J Gynecol Cancer 21:289–295CrossRefPubMedGoogle Scholar
- 13.Sala E, Kataoka M, Pandit-Taskar N et al (2010) Recurrent ovarian cancer: contrast-enhanced CT and PET/CT can accurately localize tumor recurrence and to predict patients’ survival. Radiology 257(1):125–134Google Scholar
- 23.Burger IA, Vargas HA, Apte A et al (2014) PET quantification with a histogram derived total activity metric: superior quantitative consistency compared to total lesion glycolysis with absolute or relative SUV thresholds in phantoms and lung cancer patients. Nucl Med Biol 41:410–418PubMedCentralCrossRefPubMedGoogle Scholar