Prognostic value of 18F-FDG PET/CT for identifying high- and low-risk endometrial cancer patients

Abstract

Objectives: To assess the usefulness of adding PET/CT as a preoperative test for determining the extent of endometrial cancer and discriminating low-and high-risk patients to identify candidates for surgical staging. Material and methods:We retrospectively reviewed 86 patients with pathologically proven endometrial cancer who had undergone preoperative 18 F-FDG PET/CT. The prognostic relationships between PET/CT parameters and pathology reports were assessed. Results:The SUV max was significantly higher in patients with FIGO stage IB or higher compared with those with stage IA; for stage III-IV compared with stage I-II; and for patients with lymph node metastasis compared with those without lymph node metastasis. Using 6.70 as a cut-off for SUV max , low-risk patients can be identified with a sensitivity of 92.9%. Conclusions:PET/CT imaging can be used not only for determining malignancy and lymph node involvement but also for determining candidates for surgical staging with high sensitivity.

Association Between Maximum Standardize Uptake Value and Prognostic Factors at Endometrioid Type Endometrial Carcinoma

“…Endometrial cancer is the most common gynecologic malignancy in developed countries (1)(2)(3). The prognosis of patients with endometrioid-type endometrial cancer (EEC) is excellent because they are usually at an early stage when diagnosed (2). When all stages are considered, the 5-year survival rate is 80% and more (2).…”

“…The prognosis of patients with endometrioid-type endometrial cancer (EEC) is excellent because they are usually at an early stage when diagnosed (2). When all stages are considered, the 5-year survival rate is 80% and more (2). Prognosis in EEC is related to stage, age of the patient, histological type and grade of the tumor, cervical invasion, depth of myometrial invasion, lymph node involvement and distant organ metastasis (1,2).…”

“…When all stages are considered, the 5-year survival rate is 80% and more (2). Prognosis in EEC is related to stage, age of the patient, histological type and grade of the tumor, cervical invasion, depth of myometrial invasion, lymph node involvement and distant organ metastasis (1,2). There is a significant prognostic difference between the histological types of endometrium carcinoma.…”

“…Fluorodeoxyglucose positron emission tomography / computed tomography (FDG PET/CT) is a method of imaging using metabolic changes in cancer cells (2,3). Tumor perfusion and metabolism scanning can be performed using carbon-11, fluor-18 (18F), nitrogen-13, oxygen-15 and rubidium-82 radioisotopes (4).…”

“…Thus, 18F-FDG remaining in the cell reflects glucose uptake into the cell (4). Standardize uptake value (SUV) is a marker of tumor aggression and a marker of metabolic change in cancer tissues (2)(3)(4).…”