title: Quantitative metabolic parameters measured on F-18 FDG PET/CT predict survival after relapse in patients with relapsed epithelial ovarian cancer.
abstract: OBJECTIVE
  This study aimed to evaluate the prognostic value of quantitative metabolic parameters measured on F-18 FDG PET/CT (FDG PET/CT) at the time of the first relapse in patients with relapsed epithelial ovarian cancer (EOC).
  
  
  METHODS
  Fifty-six relapsed EOC patients were retrospectively included. Quantitative metabolic parameters including maximum standardized uptake value (SUVmax), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG) were measured on FDG PET/CT at the time of the first relapse. Post-relapse survival (PRS) was calculated from the date of diagnosis of relapsed disease to the date of death or last follow-up. Univariate and multivariate analyses for PRS were performed using clinical and quantitative metabolic parameters.
  
  
  RESULTS
  Thirty-two patients died from the disease during the follow-up period (median: 46.2 months). On univariate and multivariate analyses, the platinum-free interval, type of second-line treatment, WBMTV, and WBTLG were all significant prognostic factors for PRS. The subgroup of patients who were platinum-sensitive with low WBMTV and low WBTLG showed better prognosis, when compared with other subgroups (log-rank test, p<0.001). Patients treated with secondary cytoreductive surgery (SCS) followed by second-line chemotherapy showed significantly longer duration of PRS than patients treated with second-line chemotherapy only (mean PRS=61 vs. 36 months, χ(2)=8.68, p=0.032).
  
  
  CONCLUSIONS
  Our results suggest that quantitative metabolic parameters measured on FDG PET/CT at the time of the first relapse have significant predictive values for PRS. Incorporating quantitative metabolic parameters and conventional clinical parameters has a superior prognostic discrimination compared with conventional clinical parameters alone.
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea. Electronic address: omh4ever@gmail.com.
authors.forename: Choon-Young
authors.initials: CY
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea. Electronic address: syjeong@knu.ac.kr.
authors.forename: Shin Young
authors.initials: SY
authors.lastname: Jeong
authors.affiliation: Department of Obstetrics and Gynecology, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Gun Oh
authors.initials: GO
authors.lastname: Chong
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Son
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Ji-hoon
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Do-Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Byeong-Cheol
authors.initials: BC
authors.lastname: Ahn
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, Daegu, Republic of Korea.
authors.forename: Jaetae
authors.initials: J
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D000077216:Carcinoma, Ovarian Epithelial; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006019:Glycolysis; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000401:mortality / Q000628:therapy; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: F-18 FDG PET/CT; Prognosis prediction; Relapsed epithelial ovarian cancer; Whole-body metabolic tumor volume; Whole-body total lesion glycolysis