Prognostic value of preoperative intratumoral FDG uptake heterogeneity in patients with epithelial ovarian cancer.
OBJECTIVE
To investigate the prognostic value of intratumoral FDG uptake heterogeneity (IFH) derived from PET/CT in patients with epithelial ovarian cancer (EOC).


METHODS
We retrospectively reviewed patients with pathologically proven epithelial ovarian cancer who underwent preoperative18F-FDG PET/CT scans. PET/CT parameters such as maximum and average standardized uptake values (SUVmaxand SUVavg), sum of all metabolic tumour volume (MTV), cumulative total lesion glycolysis (TLG) and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with disease-free survival (DFS).


RESULTS
Clinicopathological data were reviewed for 61 eligible patients. The median duration of DFS was 13 months (range, 6-26 months), and 18 (29.5 %) patients experienced recurrence. High IFH values were associated with tumour recurrence (P = 0.005, hazard ratio 4.504, 95 % CI 1.572-12.902). The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P = 0.002, log-rank test). Moreover, there were significant differences in DFS (P = 0.009) and IFH (P = 0.040) between patients with and without recurrence.


CONCLUSIONS
Preoperative IFH measured by18F-FDG PET/CT was significantly associated with EOC recurrence. FDG-based heterogeneity could be a useful and potential predicator of EOC recurrence before treatment.


CONCLUSIONS
• Preoperative IFH was significantly associated with recurrence of EOC • Disease-free survival significantly differed in groups categorized by IFH • FDG-based heterogeneity could be a potential predicator of EOC recurrence before treatment.
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Maria
M
Lee
Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Hyunjong
H
Lee
Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Gi Jeong
GJ
Cheon
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Hee Seung
HS
Kim
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. chhkmj@gmail.com.
Hyun Hoon
HH
Chung
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Jae-Weon
JW
Kim
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Noh-Hyun
NH
Park
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Yong Sang
YS
Song
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000378:metabolism; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D057234:Preoperative Period; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D013997:Time Factors
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
18F-FDG PET/CT; Epithelial ovarian cancer; Intratumoral FDG uptake heterogeneity; Preoperative; Recurrence