Prognostic value of metabolic tumor volume and total lesion glycolysis from 18F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma

Liu, Dou Dou; Li, Jianfang; Li, Xiaomao; Xie, Liangjun; Qin, Lu‐Ping; Peng, Fangyu; Cheng, Mu-Hua

doi:10.3802/jgo.2019.30.e89

Cited by 8 publications

(9 citation statements)

References 29 publications

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“…The difference in SUV max values of the primary tumor according to nodal metastasis was not statistically significant; however, the MTV and TLG values of the primary tumors were significantly higher in patients with nodal metastasis. This was compatible with previous studies ( 5 , 9 ). These findings also show the superiority of MTV and TLG to SUV max .…”

Section: Discussionsupporting

confidence: 94%

“…Liu et al ( 9 ) determined the cut-off value for TLG as 51.7 g and revealed a sensitivity of 84.2% and a specificity of 77.3% for TLG in distinguishing high-risk and low-risk diseases (AUC: 0.778). Similarly, our study revealed significantly higher TLG and MTV values in the high-risk group, whereas no difference in SUV max values.…”

Section: Discussionmentioning

confidence: 99%

“…SUV max represents the measurement from only one voxel of the most hypermetabolic area of a tumor lesion and only shows the highest intensity of 18 F-FDG uptake, thus it cannot reflect the whole tumor metabolic burden and can be affected by various patient characteristics and imaging parameters. The SUV max has some limitations and it cannot be used to assess the overall glucose metabolic activity of a tumor mass, thus other useful PET parameters are used, which can better reflect metabolic tumor burden than SUV max , such as metabolic tumor volume (MTV) to measure the overall glucose metabolic activity of a tumor lesion and total lesion glycolysis (TLG) that combines the information of metabolic activity and tumor volume ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

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The Evaluation of Preoperative 18F-FDG PET/CT in Patients with Endometrial Cancer and the Correlation Between PET Parameters and Postoperative Pathology Results

Topuz¹,

Aksu²,

Erinç³

et al. 2022

Mirt

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Objectives: Endometrial cancer (EC) is the most common gynecological malignancy. The 18 fluorine-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) is used for initial staging, evaluating treatment response, and detecting recurrence. This study aimed to investigate the diagnostic value of preoperative PET/CT in EC staging and determine the volumetric PET parameters that are accurate predictors of histopathological tumor characteristics. Methods: Preoperative PET/CT data of 66 patients with EC were retrospectively analyzed. Patients were divided into low and high-risk groups according to the European Society for Medical Oncology criteria. The maximum standardized uptake value (SUV max ), SUV mean , metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary lesion and pathological lymph nodes were noted. The International Federation of Gynecology and Obstetrics (FIGO) classifications, histopathology, the depth of myometrial invasion (MI), lymph node metastasis (LNM), cervical stromal invasion (CSI), and tumor sizes were noted. Results: The SUV max , TLG, and MTV values of high and low-risk groups were significantly different. TLG was the most useful parameter in differentiating risk groups. PET/CT had 90% sensitivity, 96.3% specificity, 81.8% positive predictive value, 98.1% negative predictive value, and 95.45% accuracy in assessing LNM. MTV and TLG values in patients with non-endometrioid pathology were higher than those with endometrioid. The SUV max , MTV, and TLG of patients with deep MI were higher than those with superficial MI. TLG values of patients with CSI were higher than those without CSI. Patients with LNM had higher MTV and TLG values than those without LNM. A significant difference was found in TLG, MTV, and SUV max values between patients with FIGO stage I-II and patients with FIGO stage III and above. Conclusion: SUV and volumetric parameters obtained from PET/CT, especially TLG, are strong predictors of tumor characteristics, such as MI and CSI, FIGO stages, and LNM, and are useful in noninvasively defining the risk groups in the preoperative period.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Evaluation of Preoperative 18F-FDG PET/CT in Patients with Endometrial Cancer and the Correlation Between PET Parameters and Postoperative Pathology Results

Topuz¹,

Aksu²,

Erinç³

et al. 2022

Mirt

View full text Add to dashboard Cite

show abstract

“…The relationship between TLG of primary lesions determined by PET/CT and LNM has been described in various cancers such as oesophageal [16] thyroid [17], breast [18] and endometrial cancers [19]. Researchers have reported that TLG was superior to SUV max for predicting LNM in thyroid carcinoma [17] and endometrial carcinoma [19]. Yilmaz et al [18] concluded that TLG of primary lesions was related to axillary LNM and systemic metastasis of breast cancer; they also found that TLG of primary lesions was an independent prognostic factor for overall survival in breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Relationship between total lesion glycolysis of primary lesions based on 18F-FDG PET/CT and lymph node metastasis in gastric adenocarcinoma: a cross-sectional preliminary study

Xue

Wang

et al. 2021

Nuclear Medicine Communications

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ObjectivesWe explored the relationship between lymph node metastasis (LNM) and total lesion glycolysis (TLG) of primary lesions determined by 18 fluoro-2deoxyglucose PET/computed tomography (18F-FDG PET/CT) in patients with gastric adenocarcinoma, and evaluated the independent effect of this association. MethodsThis retrospective study included 106 gastric adenocarcinoma patients who were examined by preoperative 18F-FDG PET/CT imaging between April 2016 and April 2020. We measured TLG of primary gastric lesions and evaluated its association with LNM. Multivariate logistic regression and a two-piece-wise linear regression were performed to evaluate the relationship between TLG of primary lesions and LNM. ResultsOf the 106 patients, 75 cases (71%) had LNM and 31 cases (29%) did not have LNM. Univariate analyses revealed that a per-SD increase in TLG was independently associated with LNM [odds ratio (OR) = 2.37; 95% confidence interval (CI), 1.42-3.98; P = 0.0010]. After full adjustment of confounding factors, multivariate analyses exhibited that TLG of primary lesions was still significantly associated with LNM (OR per-SD: 2.20; 95% CI, 1.16-4.19; P = 0.0164). Generalized additive model indicated a nonlinear relationship and saturation effect between TLG of primary lesions and LNM. When TLG of primary lesions was <23.2, TLG was significantly correlated with LNM (OR = 1.26; 95% CI, 1.07-1.48; P = 0.0053), whereas when TLG of primary lesions was ≥ 23.2, the probability of LNM was greater than 60%, gradually reached saturation effect, as high as 80% or more. ConclusionsIn this preliminary study, there were saturation and segmentation effects between TLG of primary lesions determined by preoperative 18F-FDG PET/CT and LNM. When TLG of primary lesions was ≥ 23.2, the probability of LNM was greater than 60%, gradually reached saturation effect, as high as 80% or more. TLG of primary lesions is helpful in the preoperative diagnosis of LNM in patients with gastric adenocarcinoma. Nucl Med Commun 43: 114-121

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“…Total lesion glycolysis (TLG) and metabolic tumor volume (MTV) are more complicated values that reflect both tracer uptake and the volume of the tumor. They have been recognized as useful indictors for various tumors; however, these values depend on the tumor volume as well as the selected threshold value of SUV and are mainly used for evaluating therapeutic response [ 29 , 30 , 31 , 32 , 33 ]. A recent meta-analysis showed that TLG and MTV were better predictors of treatment outcomes than SUVmax and SUVmean in lung cancer [ 34 ].…”

Section: Quantitative Parameters For Response Evaluation With Petmentioning

confidence: 99%

Positron Emission Tomography for Response Evaluation in Microenvironment-Targeted Anti-Cancer Therapy

2020

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Therapeutic response is evaluated using the diameter of tumors and quantitative parameters of 2-[18F] fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET). Tumor response to molecular-targeted drugs and immune checkpoint inhibitors is different from conventional chemotherapy in terms of temporal metabolic alteration and morphological change after the therapy. Cancer stem cells, immunologically competent cells, and metabolism of cancer are considered targets of novel therapy. Accumulation of FDG reflects the glucose metabolism of cancer cells as well as immune cells in the tumor microenvironment, which differs among patients according to the individual immune function; however, FDG-PET could evaluate the viability of the tumor as a whole. On the other hand, specific imaging and cell tracking of cancer cell or immunological cell subsets does not elucidate tumor response in a complexed interaction in the tumor microenvironment. Considering tumor heterogeneity and individual variation in therapeutic response, a radiomics approach with quantitative features of multimodal images and deep learning algorithm with reference to pathologic and genetic data has the potential to improve response assessment for emerging cancer therapy.

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Prognostic value of metabolic tumor volume and total lesion glycolysis from ¹⁸F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma

Cited by 8 publications

References 29 publications

The Evaluation of Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Endometrial Cancer and the Correlation Between PET Parameters and Postoperative Pathology Results

The Evaluation of Preoperative <sup>18</sup>F-FDG PET/CT in Patients with Endometrial Cancer and the Correlation Between PET Parameters and Postoperative Pathology Results

Relationship between total lesion glycolysis of primary lesions based on 18F-FDG PET/CT and lymph node metastasis in gastric adenocarcinoma: a cross-sectional preliminary study

Positron Emission Tomography for Response Evaluation in Microenvironment-Targeted Anti-Cancer Therapy

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