Prognostic value of 18F-FDG PET/CT volumetric parameters in recurrent epithelial ovarian cancer

abstract

OBJECTIVE:

Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from ¹⁸F-FDG PET/CT are emerging prognostic biomarkers in various solid neoplasms. These volumetric parameters and the SUV_max have shown to be useful criteria for disease prognostication in preoperative and post-treatment epithelial ovarian cancer (EOC) patients. The purpose of this study was to evaluate the utility of ¹⁸F-FDG PET/CT measurements to predict survival in patients with recurrent EOC.

MATERIAL AND METHODS:

Twenty-six patients with EOC who underwent a total of 31 ¹⁸F-FDG PET/CT studies for suspected recurrence were retrospectively included. SUV_max and volumetric parameters whole-body MTV (wbMTV) and whole-body TLG (wbTLG) with a threshold of 40% and 50% of the SUV_max were obtained. Correlation between PET parameters and progression-free survival (PFS) and the survival analysis of prognostic factors were calculated.

RESULTS:

Serous cancer was the most common histological subtype (76.9%). The median PFS was 12.5 months (range 10.7-20.6 months). Volumetric parameters showed moderate inverse correlation with PFS but there was no significant correlation in the case of SUV_max. The correlation was stronger for first recurrences. By Kaplan-Meier analysis and log-rank test, wbMTV 40%, wbMTV 50% and wbTLG 50% correlated with PFS. However, SUV_max and wbTLG 40% were not statistically significant predictors for PFS.

CONCLUSION:

Volumetric parameters wbMTV and wbTLG 50% measured by ¹⁸F-FDG PET/CT appear to be useful prognostic predictors of outcome and may provide valuable information to individualize treatment strategies in patients with recurrent EOC.