The Volume-metabolic Combined Parameters from (18)F-FDG PET/CT May Help Predict the Outcomes of Cervical Carcinoma

Abstract

Rationale and objectives: The aim of this study was to evaluate the prognostic value of 18-fluoro-2-deoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) volume-metabolic combined parameters in patients with cervical carcinoma.

Materials and methods: We retrospectively reviewed 91 consecutive patients' whole-body FDG-PET/CT images, and further measured and calculated FDG PET/CT volume-metabolic parameters, including cervical metabolic tumor volume (CMTV), cervical total lesion glycolysis (CTLG), whole-body metabolic tumor volume (WB-MTV), whole-body total lesions glycolysis (WB-TLG). The prognostic value of these tumor volume-metabolic measures was assessed by Cox Proportional Hazard Regression Analysis.

Results: The overall survival (OS) was 88.8% for patients with low CMTV (≤53.75 mL) and 45.5% for those with high CMTV (>53.75 mL), respectively (P < 0.01, 95% confidence interval). Univariate analysis showed that CMTV and CTLG were significant prognostic factors for OS, in addition to International Federation of Gynecology and Obstetrics (FIGO) stage, age, lymphadenopathy, and maximum standardized uptake value (SUVmax) (P < 0.05 for all). On multivariate analysis, CMTV remained significant for OS, in addition to FIGO stage (P < 0.05 for all). CMTV remains as prognostic factor for OS regardless of patients' FIGO stages (P < 0.05). In patients in the metastatic diseases group, univariate and multivariate analyses demonstrated that CMTV, WB-MTV, and WB-TLG were independent prognostic factors for OS (P < 0.05 for all).

Conclusion: CMTV, WB-MTV, and WB-TLG are reliable prognostic factors for patients with cervical carcinoma and should be included in FDG-PET/CT reports to guide referral clinicians for risk-adapted therapies.

Keywords: (18)F-FDG PET/CT; Cervical carcinoma; metabolic tumor volume; prognostic value; total lesion glycolysis.