title: Pre- and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer.
abstract: To describe the evolution and to assess the predictive value of metabolic parameters with different SUV threshold segmentations calculated from two 18F-FDG-PET/CT, one prior to and the other one during concomitant chemoradiation therapy (CCRT), for locally-advanced cervical cancer (LACC).
  
  
  
  53 patients treated for LACC by CCRT underwent FDG-PET/CT before treatment (PET1) and another one at 40Gy (PET2). The PET analyzed parameters were: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTVs were automatically segmented using various percentage SUVmax thresholds (30-70%) and fixed SUV thresholds (all voxels with SUV >1-20). The parameters' predictive capabilities for disease-free (DFS) and overall survival (OS) were assessed using the Harrell's C-index (c) and Cox regression model.
  
  
  
  Depending on the SUVmax threshold, the relative decreases in MTV and TLG from PET1 to PET2 were, on average, 65% (range: 63-70%) and 85% (range: 83-86%), respectively. The strongest predictive threshold segmentations were 55% SUVmax in PET1 and 32% in PET2. Significant predictors of DFS in multivariate analysis (c=0.82) were MTV1 (55% SUVmax) in PET1 and TLG2 (32% SUVmax) in PET2. MTV1 (55%) was the most significant OS predictor.
  
  
  
  MTV and TLG calculated with a threshold of 55% SUVmax and 32% SUVmax from pre- and per-treatment PET scans respectively, can be used to predict patient outcome after CCRT for LACC.
authors: Radiotherapy Department, Centre Eugene Marquis, Rennes, France. Electronic address: j.leseur@rennes.unicancer.fr.
authors: Julie
authors: J
authors: Leseur
authors: INSERM, U1099, University Rennes 1, LTSI, France; Keosys Medical Imaging, Saint-Herblain, France.
authors: Geoffrey
authors: G
authors: Roman-Jimenez
authors: Nuclear Medicine Department, Centre Eugene Marquis, Rennes, France.
authors: Anne
authors: A
authors: Devillers
authors: INSERM, U1099, University Rennes 1, LTSI, France; School of Statistics, Universidad Nacional de Colombia, Colombia.
authors: Juan D
authors: JD
authors: Ospina-Arango
authors: Radiotherapy Department, Centre Eugene Marquis, Rennes, France.
authors: Daniele
authors: D
authors: Williaume
authors: Radiotherapy Department, Centre Eugene Marquis, Rennes, France; INSERM, U1099, University Rennes 1, LTSI, France.
authors: Joel
authors: J
authors: Castelli
authors: Keosys Medical Imaging, Saint-Herblain, France.
authors: Pierre
authors: P
authors: Terve
authors: Gynecology and Obstetrics Department, CHU Anne-de-Bretagne - Rennes, France.
authors: Vincent
authors: V
authors: Lavoue
authors: Nuclear Medicine Department, Centre Eugene Marquis, Rennes, France.
authors: Etienne
authors: E
authors: Garin
authors: Nuclear Medicine Department, Centre Eugene Marquis, Rennes, France.
authors: Florence
authors: F
authors: Lejeune
authors: INSERM, U1099, University Rennes 1, LTSI, France.
authors: Oscar
authors: O
authors: Acosta
authors: Radiotherapy Department, Centre Eugene Marquis, Rennes, France; INSERM, U1099, University Rennes 1, LTSI, France.
authors: Renaud
authors: R
authors: De Crevoisier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000379:methods; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006019:Glycolysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000628:therapy*
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG PET; Cervix cancer; Prognosis; Radiotherapy