European Radiology

, Volume 28, Issue 5, pp 2107–2114 | Cite as

Prognostic importance of peritoneal lesion-to-primary tumour standardized uptake value ratio in advanced serous epithelial ovarian cancer

  • Hyun Hoon ChungEmail author
  • Jae-Weon Kim
  • Noh-Hyun Park
  • Yong Sang Song
  • Gi Jeong Cheon
Nuclear Medicine



Using preoperative PET/CT, we evaluated the prognostic value of preoperative [18F]FDG uptake ratio between various metastatic lesions and primary tumour in patients with advanced serous epithelial ovarian cancer (EOC).


We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stage III, IV serous EOC who underwent preoperative [18F]FDG PET/CT scans. Clinico-pathological variables and PET/CT parameters such as maximum standardized uptake value of the ovarian cancer (SUVovary), pelvic or para-aortic LN (SUVLN), peritoneal (SUVperit) and distant extra-peritoneal (SUVdist) metastatic lesions, and the metastatic lesion-to-ovarian cancer standardized uptake value ratio were assessed.


Clinico-pathological data were retrospectively reviewed for 97 eligible patients. The median progression-free survival (PFS) was 18 months (range, 6–90 months) and 59 (60.8 %) patients experienced recurrence. In multivariate regression analysis, older age (p = 0.035, hazard ratio (HR) 1.032, 95 % CI 1.002–1.062), and high SUVperit/SUVovary (p = 0.046, HR 1.755, 95 % CI 1.011–3.047) were independent risk factors of recurrence. Patient group categorized by SUVperit/SUVovary showed significant difference in PFS (Log-Rank test, p = 0.001).


In patients with advanced serous EOC, preoperative SUVperit/SUVovary measured by [18F]FDG PET/CT provides significant incremental performance for prediction of recurrence.

Key points

• PET/CT data from advanced serous epithelial ovarian cancer patients were analysed.

• Prognostic value of SUV ratio between metastatic and primary tumour was investigated.

• SUV perit /SUV ovary provides incremental performance for prediction of recurrence.


PET scan Peritoneum Metastasis Prognosis Ovarian cancer 



Epithelial ovarian cancer


International Federation of Gynaecology and Obstetrics




Positron emission tomography


Computed tomography


Standardized uptake value


Lymph node


Peritoneal metastatic lesion


Distant extra-peritoneal metastatic lesion


Hazard ratio


Confidence interval


Overall survival



This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number : HI14C1072).

Compliance with ethical standards


The scientific guarantor of this publication is Gi Jeong Cheon.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Study subjects or cohorts overlap

Data from 73 patients in a previous study were included in the current analysis [14]. This study is different from previous one in that it performed lesion-specific analysis.


• retrospective

• diagnostic or prognostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Hyun Hoon Chung
    • 1
    Email author
  • Jae-Weon Kim
    • 1
  • Noh-Hyun Park
    • 1
  • Yong Sang Song
    • 1
  • Gi Jeong Cheon
    • 2
  1. 1.Department of Obstetrics and Gynecology, Cancer Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Nuclear Medicine, Cancer Research InstituteSeoul National University College of MedicineSeoulRepublic of Korea

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