title: The preoperative SUVmax is superior to ADCmin of the primary tumour as a predictor of disease recurrence and survival in patients with endometrial cancer.
abstract: OBJECTIVE
  The purpose of this study was to investigate the prognostic value of the minimum apparent diffusion coefficient (ADCmin) derived from diffusion-weighted MR imaging and of the maximum standardized uptake value (SUVmax) derived from PET/CT imaging of the primary tumour in patients with endometrial cancer.
  
  
  METHODS
  SUVmax reflects the highest tumour metabolism rate and ADCmin reflects the highest cellularity, and both parameters have been used for tumour grading and prediction of prognosis. The correlations between prognosis and SUVmax and ADCmin of the primary tumour were determined in 131 patients with endometrial cancer. The patients were divided into groups based on ADCmin and SUVmax cut-off values to predict recurrence and survival, which were derived from receiver operating characteristic curves. Disease-free survival (DFS) and overall survival (OS) of the groups were analysed using the Kaplan-Meier method, and differences between survival curves were evaluated using the log-rank test.
  
  
  RESULTS
  The median DFS and OS times of all patients were 19.2 and 20.5 months (follow-up periods 1-70 months for both DFS and OS), respectively. Patients with high SUVmax had significantly lower DFS (P < 0.0001) and OS (P = 0.0092) than patients with low SUVmax. Multivariate analysis showed that high SUVmax was an independent prognostic factor for both DFS (P = 0.0161) and OS (P = 0.0232).
  
  
  CONCLUSIONS
  The SUVmax of the primary tumour derived from PET/CT imaging could be an important prognostic indicator of recurrence and survival in patients with endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan. k-nakamu@cc.okayama-u.ac.jp
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nakamura
authors.forename: Ikuo
authors.initials: I
authors.lastname: Joja
authors.forename: Chikako
authors.initials: C
authors.lastname: Fukushima
authors.forename: Tomoko
authors.initials: T
authors.lastname: Haruma
authors.forename: Chiaki
authors.initials: C
authors.lastname: Hayashi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kusumoto
authors.forename: Noriko
authors.initials: N
authors.lastname: Seki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hongo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D012008:Recurrence; D014057:Tomography, X-Ray Computed