Aim: To assess the prognostic value of pretreatment18F-FDG-PET/CT quantitative metabolic parameters in patients with advanced high-grade serous ovarian cancer (HGSOC). Methods: A review of 47 patients diagnosed with advanced HGSOC between 2012 and 2020 in our center was performed, evaluating pretreatment18F-FDG-PET/CT metabolic parameters: maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and metabolic tumoral volume (MTV). Two experienced nuclear medicine physicians evaluated the images, thereby obtaining quantitative parameters semiautomatically classifying the volume of interest (VOI) as the target (t): VOI with the highest SUVmax normalized by lean body mass (SUVmax(lbm)), non target (nt) and total (sum of target and non-target VOIs). The disease-free survival (DFS) and overall survival (OS) were calculated. Optimal cutoff values with ROC curves/median values were used. The Correlation between metabolic parameters and DFS/OS was determined using univariate and survival-curves analysis. Results: The median DFS was 18 months (2.5–55) and the OS 33.6 months (2.5–92). The MTVtotal, MTV(t), TLGtotal and TLG(t) were significantly associated with DFS (p= 0.005, 0.01, 0.04 and 0.04, respectively). The patients with MTVtotal > 427.8 cm3and MTVtarget > 434 cm3had shorter DFS than the patients with lower values (18.8 versus 31 months and 15.6 versus 30,p= 0.02 and 0.01, respectively). The patients with higher TLGtotal and TLG(t) values tended to have worse DFS (p= 0.26 and 0.31, respectively). In a multivariate analysis, the MTVtotal was statistically significantly associated with DFS (p= 0.003). No correlation was found with OS. Conclusions: Pretreatment MTVtotal and MTV(t) appear to be predictive of relapse in patients with advanced HGSOC.
目的：评估治疗前18F-FDG-PET/CT定量代谢参数对晚期高级别浆液性卵巢癌（HGSOC）患者的预后价值。方法：回顾性分析2012年至2020年间在本中心确诊的47例晚期HGSOC患者，评估治疗前18F-FDG-PET/CT代谢参数：最大标准化摄取值（SUVmax）、病灶糖酵解总量（TLG）及代谢肿瘤体积（MTV）。由两位经验丰富的核医学医师评估图像，通过半自动方式将感兴趣体积（VOI）分类为目标区（t）：以去脂体重标准化的最高SUVmax区域（SUVmax(lbm)）、非目标区（nt）及总体积（目标与非目标VOI之和），并据此获取定量参数。计算无病生存期（DFS）与总生存期（OS）。采用ROC曲线/中位值确定最佳截断值。通过单变量分析与生存曲线分析明确代谢参数与DFS/OS的相关性。结果：中位DFS为18个月（2.5–55），中位OS为33.6个月（2.5–92）。MTV总量、MTV(t)、TLG总量及TLG(t)与DFS显著相关（p值分别为0.005、0.01、0.04和0.04）。MTV总量>427.8 cm³及MTV(t)>434 cm³的患者DFS较短（分别为18.8个月对31个月，15.6个月对30个月，p值分别为0.02和0.01）。TLG总量与TLG(t)较高者DFS有恶化趋势（p值分别为0.26和0.31）。多变量分析显示MTV总量与DFS具有统计学显著相关性（p=0.003）。未发现与OS存在相关性。结论：治疗前MTV总量及MTV(t)可作为晚期HGSOC患者复发的预测指标。
肿瘤(癌症)患者之家