Predictive value of 18F-FDG PET/CT in restaging patients affected by ovarian carcinoma: a multicentre study |
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| Authors: | Federico Caobelli Pierpaolo Alongi Laura Evangelista Maria Picchio Giorgio Saladini Marco Rensi Onelio Geatti Angelo Castello Iashar Laghai Cristina E. Popescu Carlotta Dolci Cinzia Crivellaro Silvia Seghezzi Margarita Kirienko Vincenzo De Biasi Fabrizio Cocciolillo Natale Quartuccio Young AIMN Working Group |
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| Affiliation: | 1.Klinik für Nuklearmedizin,Medizinische Hochschule Hannover,Hanover,Germany;2.Nuclear Medicine Unit,University of Milano-Bicocca,Milan,Italy;3.Nuclear Medicine Department,IRCSS San Raffaele Scientific Institute,Milan,Italy;4.Radiotherapy and Nuclear Medicine Unit,Veneto Institute of Oncology IOV – IRCCS,Padua,Italy;5.Nuclear Medicine Department,Hospital of Udine,Udine,Italy;6.Nuclear Medicine Department,University of Florence,Florence,Italy;7.Nuclear Medicine Department,Niguarda Ca’ Granda Hospital,Milan,Italy;8.Nuclear Medicine Department; San Gerardo Hospital, Tecnomed Foundation,University of Milan-Bicocca,Milan,Italy;9.Nuclear Medicine Department,Hospital of Treviglio,Treviglio,Italy;10.Nuclear Medicine Department, Arcispedale Santa Maria Nuova,Reggio Emilia,Italy;11.Nuclear Medicine Department,Catholic University of the Sacred Heart,Rome,Italy;12.Nuclear Medicine Unit, Department of Biomedical Sciences and of Morphological and Functional Images,University of Messina,Messina,Italy;13.Executive Committee of the Italian Association of Nuclear Medicine – Youth Section,Milan,Italy |
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| Abstract: | PurposeOvarian cancer is the eighth most common malignancy among women and has a high mortality rate. Prognostic factors able to drive an effective therapy are essential. 18F-Fluoro-2-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has been investigated in patients with epithelial ovarian cancer and showed promise in diagnosing, staging, detecting recurrent lesions and monitoring treatment response. Conversely, its prognostic role remains unclear. We aimed at assessing the prognostic value of 18F-FDG PET/CT performed in the restaging process in a multicentre study.MethodsWe evaluated 168 patients affected by ovarian carcinoma, who underwent a restaging 18F-FDG PET/CT. The presence of local recurrences, lymph node involvement and distant metastasis was recorded as well as lesion dimensions, maximum and mean standardized uptake values (SUVmax and SUVmean, respectively). Progression-free survival (PFS) and overall survival (OS) at 3 and 4 years were computed by using Kaplan-Meier curves. Increased odds ratio was assessed using Cox regression analysis testing all lesion parameters measured by PET/CT.ResultsPFS was significantly longer in patients with a negative than a positive restaging PET/CT study (3- and 4-year PFS 64 and 53 % vs 23 and 12 %, respectively; p?p?p?=?0.003]. Moreover, PET/CT showed an incremental prognostic value compared to the International Federation of Gynecology and Obstetrics (FIGO) staging system. In the analysis of patient subsets, individuals with the same FIGO stage I–II but with negative PET had a significantly better 4-year OS than patients with low FIGO stage but positive PET. This implies that patients with the same FIGO stage can be further prognostically stratified using PET (p?=?0.01). At receiver-operating characteristic (ROC) analysis, no thresholds for semiquantitative parameters were predictive of a worse outcome.Conclusion 18F-FDG PET/CT has an important prognostic value in assessing the risk of disease progression and mortality rate. An efficacious therapy planning might therefore effectively rely on 18F-FDG PET/CT findings. Semiquantitative data were not proven to be an effective tool to predict disease progression. |
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