Skip to main content

Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer.

Publication ,  Journal Article
Pinho, DF; King, B; Xi, Y; Albuquerque, K; Lea, J; Subramaniam, RM
Published in: AJR Am J Roentgenol
April 2020

OBJECTIVE. The purpose of this study is to evaluate the prognostic value of quantitative metabolic parameters from pretreatment PET/CT scans of patients with squamous cell cervical cancer. MATERIALS AND METHODS. This retrospective study included 120 patients with biopsy-proven squamous cell carcinoma of the cervix who underwent FDG PET/CT for initial tumor staging. The primary tumor maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), tumor glycolytic activity, metabolic tumor volume (MTV), and metabolic intratumoral heterogeneity index (calculated as the AUC for the cumulative standardized uptake value [SUV]-volume histogram [CSH] index) were obtained. Information on patient demographic characteristics and tumor staging were collected. Median follow-up was 27.5 months. Overall survival (OS) and progression-free survival (PFS) were calculated using a multivariate Cox proportional hazards regression model and log-rank (Mantel-Cox) test to generate Kaplan-Meier survival plots. RESULTS. The mean (± SD) age of the patients was 54.4 ± 13.1 years. Twenty-two patients had stage I disease; 58, stage II; 23, stage III; and 17, stage IV. Thirty-three patients died, 82 were living, and five were lost to follow-up and were censored; 29 patients had disease progression. The median survival was 74.9 months (95% CI, 63.6-86.9 months). A higher MTV was significantly associated with reduced OS in multivariate analysis (hazard ratio, 1.085; 95% CI, 1.036-1.136; p = 0.0005). A higher AUC-CSH index (denoting lower tumor heterogeneity) was significantly associated with increased OS (hazard ratio, 0.662; 95% CI, 0.448-0.979; p = 0.04) and PFS (hazard ratio, 0.683; 95% CI, 0.471-0.991; p = 0.045) in multivariate analysis. Kaplan-Meier survival analysis using the median value for MTV (61 mL) significantly predicted OS (p = 0.0009). CONCLUSION. Tumor heterogeneity on pretreatment PET/CT is associated with OS and PFS in patients with cervical cancer. MTV is significantly associated with OS.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

April 2020

Volume

214

Issue

4

Start / End Page

908 / 916

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Tumor Burden
  • Survival Rate
  • Retrospective Studies
  • Radiopharmaceuticals
  • Prognosis
  • Positron Emission Tomography Computed Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pinho, D. F., King, B., Xi, Y., Albuquerque, K., Lea, J., & Subramaniam, R. M. (2020). Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer. AJR Am J Roentgenol, 214(4), 908–916. https://doi.org/10.2214/AJR.19.21604
Pinho, Daniella F., Brent King, Yin Xi, Kevin Albuquerque, Jayanthi Lea, and Rathan M. Subramaniam. “Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer.AJR Am J Roentgenol 214, no. 4 (April 2020): 908–16. https://doi.org/10.2214/AJR.19.21604.
Pinho DF, King B, Xi Y, Albuquerque K, Lea J, Subramaniam RM. Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer. AJR Am J Roentgenol. 2020 Apr;214(4):908–16.
Pinho, Daniella F., et al. “Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer.AJR Am J Roentgenol, vol. 214, no. 4, Apr. 2020, pp. 908–16. Pubmed, doi:10.2214/AJR.19.21604.
Pinho DF, King B, Xi Y, Albuquerque K, Lea J, Subramaniam RM. Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters in Predicting Prognosis for Patients With Cervical Cancer. AJR Am J Roentgenol. 2020 Apr;214(4):908–916.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

April 2020

Volume

214

Issue

4

Start / End Page

908 / 916

Location

United States

Related Subject Headings

  • Uterine Cervical Neoplasms
  • Tumor Burden
  • Survival Rate
  • Retrospective Studies
  • Radiopharmaceuticals
  • Prognosis
  • Positron Emission Tomography Computed Tomography
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Middle Aged