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

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

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).

Methods

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.

Results

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).

Conclusions

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.

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Abbreviations

EOC:

Epithelial ovarian cancer

FIGO:

International Federation of Gynaecology and Obstetrics

18F[FDG]:

18F-fluorodeoxyglucose

PET:

Positron emission tomography

CT:

Computed tomography

SUV:

Standardized uptake value

LN:

Lymph node

perit:

Peritoneal metastatic lesion

dist:

Distant extra-peritoneal metastatic lesion

HR:

Hazard ratio

CI:

Confidence interval

OS:

Overall survival

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Funding

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).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    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, Seoul, Republic of Korea

    Gi Jeong Cheon

Authors
  1. Hyun Hoon Chung
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  2. Jae-Weon Kim
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Corresponding author

Correspondence to Hyun Hoon Chung.

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Guarantor

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.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Chung, H.H., Kim, JW., Park, NH. et al. Prognostic importance of peritoneal lesion-to-primary tumour standardized uptake value ratio in advanced serous epithelial ovarian cancer. Eur Radiol 28, 2107–2114 (2018). https://doi.org/10.1007/s00330-017-5194-0

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  • DOI: https://doi.org/10.1007/s00330-017-5194-0

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