Identification of Metabolic Biomarkers Using Serial18F-FDG PET/CT for Prediction of Recurrence in Advanced Epithelial Ovarian Cancer.
OBJECTIVE
To evaluate the prognostic value of metabolic parameters derived from serial18F fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with advanced epithelial ovarian cancer (EOC).


METHODS
Thirteen patients with advanced EOC who received surgical staging and adjuvant platinum-based combination chemotherapy were prospectively enrolled.18F-FDG PET/CT was performed before and after the surgical staging, and after third cycle of chemotherapy. Tumor glucose metabolism at baseline and its change after operation and third cycle of chemotherapy such as changes of maximum standardized uptake values (ΔSUVmax) via18F-FDG PET/CT were measured, and assessed regarding their ability to predict recurrence.


RESULTS
Median duration of progression-free survival (PFS) was 25 months (range, 13-34), and although optimal debulking was performed in 10 patients, 5 (38.5%) patients experienced recurrence. Univariate analyses showed significant associations between recurrence and low ΔSUVmaxafter surgical staging, and low SUVmaxchange after third cycle of chemotherapy. Multivariate analysis identified low ΔSUVmaxafter third cycle of chemotherapy as an independent risk factor for recurrence (P=.047, hazard ratio (HR) 16.375, 95% CI 1.041-257.536). Kaplan-Meier survival curves showed that PFS significantly differed in groups categorized based on ΔSUVmaxafter chemotherapy (P=.001, log-rank test).


CONCLUSIONS
18F-FDG PET/CT allows for prediction of treatment response by the level of FDG uptake in terms of SUV at baseline and after chemotherapy. The metabolic response measured as ΔSUVmaxafter third cycle of chemotherapy appears to be promising predictor of recurrence in patients with advanced EOC.
Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Seoul, Republic of Korea.
Tae Hun
TH
Kim
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Junhwan
J
Kim
Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yeon-Koo
YK
Kang
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Maria
M
Lee
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Hee Seung
HS
Kim
Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Gi Jeong
GJ
Cheon
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: chhkmj@gmail.com.
Hyun Hoon
HH
Chung