Volume-based quantitative FDG PET/CT metrics and their association with optimal debulking and progression-free survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery.
OBJECTIVE
Our aim was to evaluate the associations between quantitative (18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET) uptake metrics, optimal debulking (OD) and progression-free survival (PFS) in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery.


METHODS
Fifty-five patients with recurrent ovarian cancer underwent FDG-PET/CT within 90 days prior to surgery. Standardized uptake values (SUVmax), metabolically active tumour volumes (MTV), and total lesion glycolysis (TLG) were measured on PET. Exact logistic regression, Kaplan-Meier curves and the log-rank test were used to assess associations between imaging metrics, OD and PFS.


RESULTS
MTV (p = 0.0025) and TLG (p = 0.0043) were associated with OD; however, there was no significant association between SUVmax and debulking status (p = 0.83). Patients with an MTV above 7.52 mL and/or a TLG above 35.94 g had significantly shorter PFS (p = 0.0191 for MTV and p = 0.0069 for TLG). SUVmax was not significantly related to PFS (p = 0.10). PFS estimates at 3.5 years after surgery were 0.42 for patients with an MTV ≤ 7.52 mL and 0.19 for patients with an MTV > 7.52 mL; 0.46 for patients with a TLG ≤ 35.94 g and 0.15 for patients with a TLG > 35.94 g.


CONCLUSIONS
FDG-PET metrics that reflect metabolic tumour burden are associated with optimal secondary cytoreductive surgery and progression-free survival in patients with recurrent ovarian cancer.


CONCLUSIONS
• Both TLG and MTV were associated with optimal tumour debulking. • There was no significant association between SUVmax and tumour debulking status. • Patients with higher MTV and/or TLG had significantly shorter PFS. • SUVmax was not significantly related to PFS.
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA. vargasah@mskcc.org.
H A
HA
Vargas
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
I A
IA
Burger
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Av, New York, NY, 10065, USA.
D A
DA
Goldman
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
M
M
Miccò
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
R E
RE
Sosa
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
W
W
Weber
Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Av, New York, NY, 10065, USA.
D S
DS
Chi
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
H
H
Hricak
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Av, room C278, New York, NY, 10065, USA.
E
E
Sala
D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D054893:Cone-Beam Computed Tomography; D065426:Cytoreduction Surgical Procedures / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D047368:Tumor Burden
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Imaging; Ovarian cancer; PET/CT; Recurrence; Secondary cytoreduction