title: Determination of an optimal standardized uptake value of fluorodeoxyglucose for positron emission tomography imaging to assess pathological volumes of cervical cancer: a prospective study.
abstract: OBJECTIVE
  To determine the optimal standardized uptake value (SUV) of (18)F-fluorodeoxyglucose ((18)F-FDG) for positron emission tomography (PET) imaging, at which the PET-defined gross tumor volume (GTVPET) best matches with the pathological volume (GTVPATH) in the cervical cancer.
  
  
  METHODS
  Ten patients with the cervical cancer who underwent surgery were enrolled in this study. The excised specimens were processed for whole-mount serial sections and H-E staining. The tumor borders were outlined in sections under a microscope, histopathological images were scanned and the GTVPATH calculated. The GTVPET was delineated automatically by using various percentages relative to the maximal SUV and absolute SUV. The optimal threshold SUV was further obtained as the value at which the GTVPET best matched with the GTVPATH.
  
  
  RESULTS
  An average of 85 ± 10% shrinkage of tissue was observed after the formalin fixation. The GTVPATH was 13.38 ± 2.80 cm(3) on average. The optimal threshold on percentile SUV and absolute SUV were 40.50% ± 3.16% and 7.45 ± 1.10, respectively. The correlation analysis showed that the optimal percentile SUV threshold was inversely correlated with GTVPATH (p<0.05) and tumor diameter (p<0.05). The absolute SUV was also positively correlated with SUVmax (p<0.05).
  
  
  CONCLUSIONS
  The pathological volume could provide the more accurate tumor volume. The optimal SUV of FDG for PET imaging by use of GTVPATH as standard for cervical cancer target volume delineation was thus determined in this study, and more cases are being evaluated to substantiate this conclusion.
authors.affiliation: Department of Radiation Oncology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
authors.forename: Hong-Jun
authors.initials: HJ
authors.lastname: Lu
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Li
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.forename: Wei-Wei
authors.initials: WW
authors.lastname: Li
authors.forename: Yong-Chun
authors.initials: YC
authors.lastname: Zhou
authors.forename: Jun-Yue
authors.initials: JY
authors.lastname: Liu
authors.forename: Sheng-Jun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.forename: Wan-Ling
authors.initials: WL
authors.lastname: Ma
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Wei
authors.forename: Mei
authors.initials: M
authors.lastname: Shi
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012016:Reference Values; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D019788:Fluorodeoxyglucose F18