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Measurement of SUVmax plus ADCmin of the primary tumour is a predictor of prognosis in patients with cervical cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The objectives of this study were to determine if measurements of the maximum standardized uptake value (SUVmax) by positron emission tomography/computed tomography and minimum apparent diffusion coefficient (ADCmin) by magnetic resonance imaging are correlated with the clinical characteristics and prognosis of primary cervical cancer.

Methods

The correlations between biological parameters and prognosis and SUVmax and ADCmin of the primary tumour were determined in 66 patients with cervical cancer before radiotherapy or concurrent chemoradiotherapy.

Results

There were significant correlations between SUVmax of the primary tumour and FIGO stage (p = 0.036), tumour maximum size (p = 0.018) and pelvic lymph node metastasis (p = 0.044). The median durations of disease-free survival (DFS) and overall survival (OS) were 16.1 and 19.2 months, respectively. The DFS and OS of patients exhibiting high SUVmax of the primary tumour were significantly lower than those of patients exhibiting low SUVmax of the primary tumour (p = 0.0171 and p = 0.0367). The OS of patients exhibiting low ADCmin of the primary tumour was significantly lower than that of patients exhibiting high ADCmin of the primary tumour (p = 0.0376). The DFS and OS of patients exhibiting high SUVmax together with low ADCmin of the primary tumour were significantly lower (p = 0.003 and p = 0.001). Multivariate analyses showed that high SUVmax together with low ADCmin of the primary tumour was an independent prognostic factor for both DFS (p = 0.0030) and OS (p = 0.0036).

Conclusion

High SUVmax together with low ADCmin of the primary tumour is an important predictive factor for identifying patients with cervical cancer who have a poor prognosis.

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References

  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108.

    Article  PubMed  Google Scholar 

  2. Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, Heintz AP, et al. Carcinoma of the cervix uteri. J Epidemiol Biostat. 2001;6(1):7–43.

    PubMed  CAS  Google Scholar 

  3. Delgado G, Bundy BN, Fowler Jr WC, Stehman FB, Sevin B, Creasman WT, et al. A prospective surgical pathological study of stage I squamous carcinoma of the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol. 1989;35(3):314–20.

    Article  PubMed  CAS  Google Scholar 

  4. Dudeck O, Zeile M, Pink D, Pech M, Tunn PU, Reichardt P, et al. Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging. 2008;27(5):1109–13.

    Article  PubMed  Google Scholar 

  5. Guo AC, Cummings TJ, Dash RC, Provenzale JM. Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. Radiology. 2002;224(1):177–83.

    Article  PubMed  Google Scholar 

  6. Taouli B, Vilgrain V, Dumont E, Daire JL, Fan B, Menu Y. Evaluation of liver diffusion isotropy and characterization of focal hepatic lesions with two single-shot echo-planar MR imaging sequences: prospective study in 66 patients. Radiology. 2003;226(1):71–8.

    Article  PubMed  Google Scholar 

  7. Zhang J, Tehrani YM, Wang L, Ishill NM, Schwartz LH, Hricak H. Renal masses: characterization with diffusion-weighted MR imaging – a preliminary experience. Radiology. 2008;247(2):458–64.

    Article  PubMed  Google Scholar 

  8. Hayashida Y, Hirai T, Morishita S, Kitajima M, Murakami R, Korogi Y, et al. Diffusion-weighted imaging of metastatic brain tumors: comparison with histologic type and tumor cellularity. AJNR Am J Neuroradiol. 2006;27(7):1419–25.

    PubMed  CAS  Google Scholar 

  9. Kanauchi N, Oizumi H, Honma T, Kato H, Endo M, Suzuki J, et al. Role of diffusion-weighted magnetic resonance imaging for predicting of tumor invasiveness for clinical stage IA non-small cell lung cancer. Eur J Cardiothorac Surg. 2009;35(4):706–10.

    Article  PubMed  Google Scholar 

  10. Taouli B, Thakur RK, Mannelli L, Babb JS, Kim S, Hecht EM, et al. Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology. 2009;251(2):398–407.

    Article  PubMed  Google Scholar 

  11. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622–35.

    Article  PubMed  Google Scholar 

  12. Sharma U, Danishad KK, Seenu V, Jagannathan NR. Longitudinal study of the assessment by MRI and diffusion-weighted imaging of tumor response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. NMR Biomed. 2009;22(1):104–13.

    Article  PubMed  Google Scholar 

  13. Gambhir SS. Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2(9):683–93.

    Article  PubMed  CAS  Google Scholar 

  14. Vesselle H, Schmidt RA, Pugsley JM, Li M, Kohlmyer SG, Vallires E, et al. Lung cancer proliferation correlates with [F-18]fluorodeoxyglucose uptake by positron emission tomography. Clin Cancer Res. 2000;6(10):3837–44.

    PubMed  CAS  Google Scholar 

  15. Buck A, Schirrmeister H, Kühn T, Shen C, Kalker T, Kotzerke J, et al. FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters. Eur J Nucl Med Mol Imaging. 2002;29(10):1317–23.

    Article  PubMed  CAS  Google Scholar 

  16. Kurokawa T, Yoshida Y, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Expression of GLUT-1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F-18]-fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary. Int J Cancer. 2004;109(6):926–32.

    Article  PubMed  CAS  Google Scholar 

  17. Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. AJR Am J Roentgenol. 2001;176(6):1449–54.

    PubMed  CAS  Google Scholar 

  18. Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol. 2001;82(1):17–21.

    Article  PubMed  CAS  Google Scholar 

  19. Mack MG, Rieger J, Baghi M, Bisdas S, Vogl TJ. Cervical lymph nodes. Eur J Radiol. 2008;66(3):493–500.

    Article  PubMed  Google Scholar 

  20. Nakamura K, Okumura Y, Kodama J, Hongo A, Kanazawa S, Hiramatsu Y. The predictive value of measurement of SUVmax and SCC-antigen in patients with pretreatment of primary squamous cell carcinoma of cervix. Gynecol Oncol. 2010;119(1):81–6.

    Article  PubMed  CAS  Google Scholar 

  21. Boyce J, Fruchter RG, Nicastri AD, Ambiavagar PC, Reinis MS, Nelson Jr JH. Prognostic factors in stage I carcinoma of the cervix. Gynecol Oncol. 1981;12(2 Pt 1):154–65.

    Article  PubMed  CAS  Google Scholar 

  22. Burghardt E, Pickel H, Haas J, Lahousen M. Prognostic factors and operative treatment of stages IB to IIB cervical cancer. Am J Obstet Gynecol. 1987;156(4):988–96.

    PubMed  CAS  Google Scholar 

  23. Van Bommel PF, Van Lindert AC, Kock HC, Leers WH, Neijt JP. A review of prognostic factors in early-stage carcinoma of the cervix (FIGO I B and II A) and implications for treatment strategy. Eur J Obstet Gynecol Reprod Biol. 1987;26(1):69–84.

    Article  PubMed  Google Scholar 

  24. Provenzale JM, Mukundan S, Barboriak DP. Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology. 2006;239(3):632–49.

    Article  PubMed  Google Scholar 

  25. Matsushima N, Maeda M, Takamura M, Takeda K. Apparent diffusion coefficients of benign and malignant salivary gland tumors. Comparison to histopathological findings. J Neuroradiol. 2007;34(3):183–9.

    PubMed  CAS  Google Scholar 

  26. Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A. Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 2006;16(7):1468–77.

    Article  PubMed  Google Scholar 

  27. Humphries PD, Sebire NJ, Siegel MJ, Olsen ØE. Tumors in pediatric patients at diffusion-weighted MR imaging: apparent diffusion coefficient and tumor cellularity. Radiology. 2007;245(3):848–54.

    Article  PubMed  Google Scholar 

  28. Naganawa S, Sato C, Kumada H, Ishigaki T, Miura S, Takizawa O. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix. Eur Radiol. 2005;15(1):71–8.

    Article  PubMed  Google Scholar 

  29. McVeigh PZ, Syed AM, Milosevic M, Fyles A, Haider MA. Diffusion-weighted MRI in cervical cancer. Eur Radiol. 2008;18(5):1058–64.

    Article  PubMed  Google Scholar 

  30. Paulino AC, Johnstone PA. FDG-PET in radiotherapy treatment planning: pandora’s box? Int J Radiat Oncol Biol Phys. 2004;59(1):4–5.

    Article  PubMed  Google Scholar 

  31. Fukui MB, Blodgett TM, Snyderman CH, Johnson JJ, Myers EN, Townsend DW, et al. Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics. 2005;25(4):913–30.

    Article  PubMed  Google Scholar 

  32. Hickeson M, Yun M, Matthies A, Zhuang H, Adam LE, Lacorte L, et al. Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET. Eur J Nucl Med Mol Imaging. 2002;29(12):1639–47.

    Article  PubMed  Google Scholar 

  33. Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. The standardized uptake value for F-18 fluorodeoxyglucose is a sensitive predictive biomarker for cervical cancer treatment response and survival. Cancer. 2007;110(8):1738–44.

    Article  PubMed  Google Scholar 

  34. Bos R, van Der Hoeven JJ, van Der Wall E, van Der Groep P, van Diest PJ, Comans EF, et al. Biologic correlates of (18)fluorodeoxyglucose uptake in human breast cancer measured by positron emission tomography. J Clin Oncol. 2002;20(2):379–87.

    Article  PubMed  CAS  Google Scholar 

  35. Higashi T, Tamaki N, Torizuka T, Nakamoto Y, Sakahara H, Kimura T, et al. FDG uptake, GLUT-1 glucose transporter and cellularity in human pancreatic tumors. J Nucl Med. 1998;39(10):1727–35.

    PubMed  CAS  Google Scholar 

  36. Ito K, Kato T, Ohta T, Tadokoro M, Yamada T, Ikeda M, et al. Fluorine-18 fluoro-2-deoxyglucose positron emission tomography in recurrent rectal cancer: relation to tumour size and cellularity. Eur J Nucl Med. 1996;23(10):1372–7.

    Article  PubMed  CAS  Google Scholar 

  37. Kim HS, Kim SY. A prospective study on the added value of pulsed arterial spin-labeling and apparent diffusion coefficients in the grading of gliomas. AJNR Am J Neuroradiol. 2007;28(9):1693–9.

    Article  PubMed  CAS  Google Scholar 

  38. Higano S, Yun X, Kumabe T, Watanabe M, Mugikura S, Umetsu A, et al. Malignant astrocytic tumors: clinical importance of apparent diffusion coefficient in prediction of grade and prognosis. Radiology. 2006;241(3):839–46.

    Article  PubMed  Google Scholar 

  39. Murakami R, Sugahara T, Nakamura H, Hirai T, Kitajima M, Hayashida Y, et al. Malignant supratentorial astrocytoma treated with postoperative radiation therapy: prognostic value of pretreatment quantitative diffusion-weighted MR imaging. Radiology. 2007;243(2):493–9.

    Article  PubMed  Google Scholar 

  40. Ho KC, Lin G, Wang JJ, Lai CH, Chang CJ, Yen TC. Correlation of apparent diffusion coefficients measured by 3 T diffusion-weighted MRI and SUV from FDG PET/CT in primary cervical cancer. Eur J Nucl Med Mol Imaging. 2009;36(2):200–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kika-ku, Okayama, 700-8558, Japan

    Keiichiro Nakamura, Junichi Kodama, Atsushi Hongo & Yuji Hiramatsu

  2. Department of Medical Radiotechnology, Okayama University Graduate School of Health Sciences, 2-5-1 Shikata-cho, Kika-ku, Okayama, 700-8558, Japan

    Ikuo Joja

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  1. Keiichiro Nakamura
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Correspondence to Keiichiro Nakamura.

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Nakamura, K., Joja, I., Kodama, J. et al. Measurement of SUVmax plus ADCmin of the primary tumour is a predictor of prognosis in patients with cervical cancer. Eur J Nucl Med Mol Imaging 39, 283–290 (2012). https://doi.org/10.1007/s00259-011-1978-7

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  • DOI: https://doi.org/10.1007/s00259-011-1978-7

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