The prognostic value of 18F-FDG PET/CT in post-operative cervical cancer patient

초록

Objectives The purpose of this study is to evaluate the role of FDG-PET imaging in altering management and providing prognostic information for uterine cervical cancer. Methods Retrospective review of cervical cancer patients who had a staging FDG-PET scan performed at Korea university guro hospital between the years 2007 and 2011. A total of 213 patients (among 212 PET scans) were analyzed in this study. Results The median follow-up time for all patients was 469 days. SUVs were available for 152 of the masses and 79 of the lymph nodes, 52 patients did not have a reported SUV (results for these patients were reported as positive or negative). The median maximum SUV was 8.75 with a range of 1 to 41 for the main tumor mass. The median maximum SUV was 5.95 with a range of 2 to 25 for the lymph node, when multiple lymph nodes were found, only the lymph node with the highest SUV was used. Lymph nodes with distant metastasis had higher SUVs than patient without metastais, 3.2 vs. 1.80 (p < 0.0007). Maximum SUV for the primary tumor > 8.0 was selected for cut-off value from ROC curve but wasn’t predictive of distant recurrence (p >0.16). However, the SUV of the lymph nodes was predictive of distant recurrence, in patients with LNs of max SUV value > 7.0 ( vs under than 7.0; p < 0.05). Conclusions FDG-PET scanning has good accuracy and predictive value in determining lymph node status. SUV of the tumor mass is prognostic for disease free survival. SUV of the lymph node is prognostic for for distant recurrence. Especially nodal SUV may be used to predict patients who would be more likely to benefit from induction chemotherapy.