PET-CT in clinical oncology

Jeong

et al. 2013

Purpose We evaluated the potential prognostic value of 18 Ffluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) in patients with stage IIIC/ IV endometrial cancer. Methods Patients with stage IIIC/IV endometrial cancer who had undergone FDG PET/CT workup for staging were enrolled. Maximum standardized uptake values (SUVmax) measured from regions of interest (ROIs) of the primary tumor (SUVt) and lymph nodes (SUVn) were correlated with overall survival (OS). The SUVn was defined as the highest SUVmax of the metastatic lymph nodes. Survival probability was assessed using the Kaplan-Meier method. Results A total of 42 patients with a median age of 55.5 years (range 32-76 years) were included. Twenty-nine percent (n =12) of patients were premenopausal and 71 % (n =30) were postmenopausal. The average SUVt was 12.9 (range 1.8-36.5), and the average SUVn was 7.3 (range 2.0-22.5). Median follow-up time was 25.9 months (range 1-84 months). Using a SUVt of 9.5 as a cutoff value, two groups with different rates were determined (P =0.026). In addition, patients with a low SUVn had significantly better OS than those with a high SUVn (P =0.003). Patients in the International Federation of Obstetrics and Gynecology (FIGO) stage IV group with SUVt≥9.5 or SUVn≥7.3 showed a significantly longer OS than the other groups.

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Metabolic Activity Measured by 18F-FDG PET/CT in Patients with Advanced Endometrial Cancer

Kim

Jeong

et al. 2013

“…18 F-FDG PET/CT has been useful as a staging tool in a variety of malignancies such as esophageal, lymphoma, lung, breast, colorectal, melanoma and head and neck cancers. The value of this test is not only in providing information about disease spread, but also in the evaluation of treatment response and prediction of long-term survival [22].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

Yoo

Lee

et al. 2012

Purpose We investigated the prognostic values of volumebased metabolic parameters by 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder carcinoma patients and compared them with other prognostic parameters. Materials and Methods We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and undergoing 18 F-FDG PET/CT. Various metabolic volume-based PET parameters of primary tumors, including maximum and average standardized uptake values (SUV max , SUV avg ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan-Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed. ResultsOf the 44 enrolled patients, cancer-or treatmentrelated death occurred in 30 (68.2 %). The mean clinical follow-up period was 22.2±10.4 m (range, 0.6-35.9 m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P < 0.001), treatment modality (P <0.001), MTV (cutoff 0 135 cm 3 , P00.001), and TLG (cutoff 0 7,090, P<0.05) were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR)02.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P00.001) and TLG (HR02.930; P<0.05) were independent prognostic factors for predicting overall survival. Conclusions In gallbladder cancer, TLG of the primary tumor, a volume-based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage.

“…18 F-FDG PET/CT has been used in a variety of malignancies such as lymphoma, esophageal, breast, colorectal, and head and neck cancers. This tool was not only useful for providing information about tumor spread but also for the evaluation of treatment response [22]. The parameters measured by 18 F-FDG PET/CT such as SUV, MTV, and TLG were thought to represent tumor burden and aggressiveness [12][13][14].…”

mentioning

confidence: 99%

Prognostic Value of Volume-Based Metabolic Parameters Measured by 18F-FDG PET/CT of Pancreatic Neuroendocrine Tumors

Kim

et al. 2014

Purpose To date, the prognostic value of 18 F-FDG PET/CT for patients with pancreatic neuroendocrine tumors (PNETs) has not been well characterized. We investigated the prognostic value of volumetric parameters using 18 F-FDG PET/CT in this patient population. Methods We retrospectively reviewed 20 cases of pathologically proven PNET in patients who had undergone pretherapeutic 18 F-FDG PET/CT. PET parameters including maximum and average standardized uptake values (SUV max , SUV ave ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were measured using a threshold SUV to determine the boundaries of the tumors. Univariate and multivariate survival analyses were performed with adjustments for PET parameters and other clinical values.Results The median clinical follow-up was 22.3 (range, 1.2-95.4) months. Cancer-related death occurred in 5 of 20 patients (25 %). Patients had clinical or pathological stages of I in seven patients, II in six patients, III in three patient, and IV in four patients. According to the WHO histological classification of subtypes, 3 patients exhibited well-differentiated PNETs, 13 patients had well-differentiated endocrine carcinomas, and 4 had poorly differentiatedendocrine carcinomas. Univariate analysis showed that tumor size (p=0.028), AJCC stage (p=0.009), T stage (p=0.028), M stage (p=0.029), treatment modality (p=0.045), MTV (p=0.003) and TLG (p=0.027) were significant predictors of overall survival. On multivariate analysis, MTV (HR=10.859, p=0.031) was a significant independent predictor of overall survival along with the AJCC stage (HR=11.556, p=0.027).