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KMID : 1137020190300060089
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Journal of Gynecologic Oncology
2019 Volume.30 No. 6 p.89 ~ p.89
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Prognostic value of metabolic tumor volume and total lesion glycolysis from 18F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma
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Liu Dou-Dou
Li Jianfang
Li Xiaomao
Xie Liangjun
Qin Luping
Peng Fangyu
Cheng Mu-Hua
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Abstract
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Objective: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC).
Methods: The patients with pathological diagnosis of EC who underwent preoperative 18F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification.
Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005).
Conclusion: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative 18F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
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KEYWORD
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Endometrial Carcinoma, Lymphatic Metastases, Tumor Volume, Metabolism, Risk Assessment
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