18F-FDG PET/CT in locally advanced cervical cancer: A review

Caresia-Aróztegui, A.P.; Delgado-Bolton, Roberto; Álvarez-Ruiz, Sara; Cózar-Santiago, M. del Puig; Orcajo-Rincón, J.; Arcocha-Torres, M. de; García-Velloso, María José

doi:10.1016/j.remnie.2018.11.005

Cited by 2 publications

(1 citation statement)

References 52 publications

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“…On the other hand, the patients show a very variable level of RGD uptake including two patients had very low RGD uptake. FDG-PET is widely used as a surrogate parameter of cell viability and glucose metabolism (35,39), while RGD uptake is used to assess integrin α v β 3 expression and angiogenic tumor cells (40). The heterogeneity of both FDG and RGD uptake within the same cancer type could be due to differences in properties such as growth rate, vascularity and necrosis in the tumor cell population (21).…”

Section: Discussionmentioning

confidence: 99%

Multi-parametric PET/MRI With FDG and RGD for Enhanced Tumor Characterization of Patients With Cervical Cancer

Ahangari

Andersen

Hansen

et al. 2022

Preprint

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Aim: The concept of personalized medicine has brought increased awareness to the importance of inter- and intra-tumor heterogeneity for cancer treatment. The aim of this study was to explore simultaneous multi-parametric PET/MRI prior to chemoradiotherapy for cervical cancer for characterization of tumors and tumor heterogeneity. Methods: Ten patients with histologically proven primary cervical cancer were examined with multi-parametric 68Ga-NODAGA-E[c(RGDyK)]2-PET/MRI for radiation treatment planning after diagnostic 18F-FDG-PET/CT. Standardized uptake values (SUV) of RGD and FDG, diffusion weighted MRI and the derived apparent diffusion coefficient (ADC), and pharmacokinetic maps obtained from dynamic contrast-enhanced MRI with the Tofts model (iAUC60, Ktrans, ve, and kep) were included in the analysis. The spatial relation between functional imaging parameters in tumors was examined by a correlation analysis and joint histograms at the voxel level. The ability of multi-parametric imaging to identify tumor tissue classes was explored using an unsupervised 3D Gaussian mixture model-based cluster analysis.Results: Functional MRI and PET of cervical cancers appeared heterogeneous both between patients and spatially within the tumors, and the relations between parameters varied strongly within the patient cohort. The strongest spatial correlation was observed between FDG uptake and ADC (median r=-0.7). There was moderate voxel-wise correlation between RGD and FDG uptake, and weak correlations between all other modalities. Distinct relations between the ADC and RGD uptake as well as the ADC and FDG uptake were apparent in joint histograms. A cluster analysis using the combination of ADC, FDG and RGD uptake suggested tissue classes which could potentially relate to tumor sub-volumes. Conclusion: A multi-parametric PET/MRI examination of patients with cervical cancer integrated with treatment planning and including estimation of angiogenesis and glucose metabolism as well as MRI diffusion and perfusion parameters is feasible. A combined analysis of functional imaging parameters indicates a potential of multi-parametric PET/MRI to contribute to a better characterization of tumor heterogeneity than the modalities alone. However, the study is based on small patient numbers and further studies are needed prior to the future design of individually adapted treatment approaches based on multi-parametric functional imaging.

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Section: Discussionmentioning

confidence: 99%

Multi-parametric PET/MRI With FDG and RGD for Enhanced Tumor Characterization of Patients With Cervical Cancer

Ahangari

Andersen

Hansen

et al. 2022

Preprint

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Prognostic value of post-radiation serum squamous cell carcinoma antigen and primary tumor regression for cervical squamous cell carcinoma

Wan

Yan

Liu

et al. 2020

CBM

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OBJECTIVE: In this study, we determined the prognostic values of magnetic resonance imaging (MRI)-based primary tumor regression and serum squamous cell carcinoma antigen (SSCC-Ag) levels 4 weeks after definitive radiotherapy (RT) in cervical squamous cell carcinoma (CSCC) patients. METHODS: This was a retrospective study involving 218 patients with histologically confirmed CSCC (stages IB-IVA). All the patients received definitive RT. Pre- and post-RT pelvic MRI and SSCC-Ag levels were measured. Locoregional control (LRC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated, and possible OS prognostic factors were analyzed. RESULTS: The median follow-up time was 25.57 (1.73–58.93) months. Thirty-six and 68 patients died and experienced recurrence, respectively, and the primary tumors of 130 (59.6%) and 88 (40.4%) patients exhibited complete response (CR) and non-CR, respectively. The 3-year OS, DFS, LRC, and DMFS rates were significantly higher in the CR than in the non-CR patients (85.2% vs. 67.9%, 78.9% vs. 39.0%, 93.4% vs. 63.8%, and 83.4% vs. 54.5%, respectively; p< 0.05). The 3-year OS, DFS, LRC, and DMFS rates were significantly lower in the patients with high post-RT SSCC-Ag levels than in those with low post-RT SSCC-Ag levels (38.0% vs. 83.9%, 21.2% vs. 66.3%, 73.0% vs. 84.9%, and 26.5% vs. 79.0%, respectively; p<0.05). Multivariate analyses indicated that SSCC-Ag levels were an independent OS predictor (HR: 5.749, 95% CI: 2.598–12.723, p< 0.001). CONCLUSION: Post-RT SSCC-Ag levels are OS independent prognostic factors in CSCC patients receiving RT. Timely and optimized treatment plans for CSCC patients after 4 weeks of RT are necessary when patients with persistent tumor and/or positive SSCC-Ag.

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18F-FDG PET/CT in locally advanced cervical cancer: A review

Cited by 2 publications

References 52 publications

Multi-parametric PET/MRI With FDG and RGD for Enhanced Tumor Characterization of Patients With Cervical Cancer

Multi-parametric PET/MRI With FDG and RGD for Enhanced Tumor Characterization of Patients With Cervical Cancer

Prognostic value of post-radiation serum squamous cell carcinoma antigen and primary tumor regression for cervical squamous cell carcinoma

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