European Radiology

, Volume 25, Issue 11, pp 3348–3353 | Cite as

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

  • H. A. VargasEmail author
  • I. A. Burger
  • D. A. Goldman
  • M. Miccò
  • R. E. Sosa
  • W. Weber
  • D. S. Chi
  • H. Hricak
  • E. Sala



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.

Key Points

• 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.


Ovarian cancer PET/CT Imaging Recurrence Secondary cytoreduction 



18 F-fluorodeoxyglucose


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.


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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • H. A. Vargas
    • 1
    Email author
  • I. A. Burger
    • 1
  • D. A. Goldman
    • 2
  • M. Miccò
    • 1
  • R. E. Sosa
    • 1
  • W. Weber
    • 1
  • D. S. Chi
    • 3
  • H. Hricak
    • 1
  • E. Sala
    • 1
  1. 1.Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA

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