Preoperative [ 18F]FDG PET/CT predicts recurrence in patients with epithelial ovarian cancer

초록

To determine whether [ 18F]FDG uptake on PET/CT imaging before surgical staging has prognostic significance in patients with epithelial ovarian cancer (EOC). Methods: Patients with EOC were imaged with integrated PET/CT before surgical staging. Hypermetabolic lesions were measured as the standardized uptake value (SUV) in primary and metastatic tumors. SUV distribution was divided into two regions at the level of umbilicus, and the impact of the ratio between above and below umbilicus (SUV location ratio) on progression-free survival (PFS) was examined using Cox proportional hazards regression. Results: Between January 2004 and December 2009, 55 patients with EOC underwent preoperative PET/CT. The median duration of PFS was 11 months (range, 3 to 43 months), and twenty (36.4%) patients experienced recurrence. In univariate analysis, high SUV location ratio (p=0.002; hazard ratio [HR], 1.974; 95% confidence interval [CI], 1.286 to 3.031) was significantly associated with recurrence. Malignant mixed mullerian tumor compared with endometrioid histology was also shown to have significance. In multivariate analysis, high SUV location ratio (p=0.005; HR, 2.418; 95% CI, 1.1315 to 4.447) and histology (serous, mucinous, and malignant mixed mullerian tumor compared with endometrioid type) were significantly associated with recurrence. Patients were categorized into two groups according to SUV location ratio (<0.3934 vs. ≥0.3934), and the Kaplan-Meier survival graph showed a significant difference in PFS between the groups (p=0.0021; HR, 9.47, log-rank test). Conclusion: SUV distribution showed a significant association with recurrence in patients with EOC, and may be a useful predictor of recurrence. © 2012. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

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