Tomoaki Otani - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Kanae Miyake - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Takayoshi Ishimori - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Aki Kido - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Tsuneo Saga - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
Yuji Nakamoto - Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan

Objective(s): The aim of this study was to assess the prognostic value of pretreatment Positron emission tomography / computed tomography using ۱۸F-fluorodeoxyglucose (FDG-PET/CT) in cervical cancer according to two major histologic types.Methods: Eighty-three squamous cell carcinoma (SCC) patients and ۳۵ adenocarcinoma (AC) patients who underwent pretreatment FDG-PET/CT were retrospectively analyzed. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were calculated. Kaplan-Meier analyses were used to compare correlations between each PET parameter and overall survival (OS). The prognostic values of imaging and clinical parameters were assessed using uni- and multivariable Cox proportional hazard models.Results: SUVmax, SUVmean, and TLG were significantly higher in SCC than in AC (p<۰.۰۱ each). No significant difference in MTV was seen between the two groups (p=۰.۱۰). As for Kaplan-Meier analyses, in SCC, patients with SUVmax, SUVmean, MTV, and TLG exceeding cutoff values tended to show worse OS than patients with lower values (p=۰.۰۷, p=۰.۲۷, p<۰.۰۱, and p=۰.۰۱, respectively, for OS). On the other hand, in AC, patients with MTV and TLG exceeding cutoff values showed significantly worse PFS and OS (p<۰.۰۱ each for OS), while SUVmax and SUVmean were unrelated to OS (p=۰.۹۱ and p=۰.۸۳, respectively for OS). As for multivariable analyses, in SCC, TLG was identified as an independent prognostic factor for OS (p=۰.۰۱). In AC, MTV was identified as an independent prognostic factor for OS (p=۰.۰۲).Conclusion: Our preliminary data suggest that FDG-PET/CT would be useful for predicting prognosis in cervical cancer, although the clinical significance of quantitative values may differ according to histopathological type.

cervical uterine cancer, uterine cervical adenocarcinoma, Prognostic Value, FDG