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Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer

  • Oncology
  • Published:
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Abstract

Objectives

To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC).

Methods

We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative 18F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUVmax and SUVavg), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS).

Results

Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6–26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572–12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence.

Conclusions

Preoperative IFH measured by 18F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment.

Key Points

• Preoperative IFH was significantly associated with recurrence of EOC

• Disease-free survival significantly differed in groups categorized by IFH

• FDG-based heterogeneity could be a potential predicator of EOC recurrence before treatment

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Abbreviations

18F-FDG:

18F-fluorodeoxyglucose

CT:

Computed tomography

DFS:

Disease-free survival

EOC:

Epithelial ovarian cancer

FIGO:

International Federation of Gynaecology and Obstetrics

IFH:

Intratumoral FDG uptake heterogeneity

MTV:

Metabolic tumour volume

TLG:

Total lesion glycolysis

PET:

Positron emission tomography

SD:

Standard deviation

SUV:

Standardized uptake value

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Acknowledgments

The scientific guarantor of this publication is Gi Jeong Cheon. 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 work was supported by the Research Resettlement Fund for new faculty of Seoul National University, and by grant no. 3420130200 (2013-0362) from the SK Telecom Research Fund and grant no. 0320140270 (2014-1040) from the Seoul National University Hospital Research Fund. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Maria Lee, Hee Seung Kim, Hyun Hoon Chung, Jae-Weon Kim, Noh-Hyun Park & Yong Sang Song

  2. Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Hyunjong Lee & Gi Jeong Cheon

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  1. Maria Lee
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Correspondence to Hyun Hoon Chung.

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Lee, M., Lee, H., Cheon, G.J. et al. Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer. Eur Radiol 27, 16–23 (2017). https://doi.org/10.1007/s00330-016-4368-5

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  • DOI: https://doi.org/10.1007/s00330-016-4368-5

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