18F-fluoro-2-deoxy-D-glucose positron emission tomography standard uptake value ratio as an indicator of cervical cancer chemoradiation therapeutic response

Abstract

Hypothesis: A ratio of 3 months of posttherapy to pretherapy 2-[F]fluoro-2-deoxy-d-glucose positron emission tomography with computed tomography (F-FDG PET/CT) standard uptake values (SUVs) predicts progression-free survival after chemoradiation in patients with stages IB2 to IVA cervical cancer.

Methods: This retrospective review included 51 patients who received treatments of daily pelvic radiation and once-weekly cisplatin chemotherapy followed by brachytherapy. Posttherapy confirmatory surgical or cytologic pathology was done a median of 7 days after 3-month F-FDG PET/CT.

Results: All 51 patients receiving chemoradiation achieved at least a partial metabolic response (ie, >25% decrease in F-FDG PET/CT SUV) in the expected region of the cervix. A ratio of less than 0.33 for posttherapy to pretherapy F-FDG PET/CT SUVs of the expected area of the cervix was associated with a 35% improvement in 6-month progression-free survival.

Conclusions: In patients with cervical cancer, the 3-month posttherapy F-FDG PET/CT value is an indicator of therapeutic response to chemoradiation and needs further validation in clinical trials.