The predictive recurrence value of MTV-s as an 18F-FDG PET/CT index in patients with IIB-IVA cervical cancer

ABSTRACT

Objectives: The aim of this study was to explore the predictive recurrence value of the PET/CT index and some clinical features in patients with IIB-IVA cervical cancer.

Methods: This was a retrospective analysis of 84 patients with cervical cancer who underwent 18 F-FDG PET/CT scans before treatment. MTV-s is the sum of the metabolic volume of the primary cervical lesion (MTV-C) and the metabolic volume of the pelvic and abdominal paravascular metastatic lymph nodes (MTV-LN). We analyzed the relationships between clinical characteristics (age, FIGO stage, pathological pattern, degree of differentiation, tumor size, presence of LN metastasis), PET/CT index (SUVmax-C, SUVmax-LN, MTV-C, MTV-LN, MTV-s), and recurrence of cervical cancer using the chi-square test; the ROC curve was used to determine the PET/CT boundary parameters; and the COX proportional risk model was used for univariate and multivariate analysis of clinical features and the PET/CT index. The survival curve was drawn using the Kaplan–Meier method, comparing different groups by the log-rank test.

Results: Eighty-four patients were included. During the observation period, 26 patients had tumor recurrence (31.0%). Univariate analysis showed that lymph node metastasis, lymph node SUVmax (SUVmax-LN), MTV-C, MTV-LN, and MTV-s were associated with PFS. MTV-s > 27.36 cm³ was an independent risk factor for PFS (P = 0.037). There were 41 patients with MTV-s > 27.36 cm³, and 19 of them had tumor recurrence (46.3%). There were 43 patients with MTV-s ≤ 27.36 cm³, 7 of whom had tumor recurrence (16.3%).

Conclusion: MTV-s can predict recurrence in patients with stage IIB-IVA cervical cancer, with a critical value of 27.36 cm³. PET/CT can help clinicians judge the prognosis of patients more comprehensively.

KEYWORDS:

• Cervical cancer
• PET/CT
• 18F-FDG
• SUVmax
• recurrence

Declaration of financial/other relationships

The authors have no conflicts of interest.

The contents of the paper and the opinions expressed within are those of the authors, and it was the decision of the authors to submit the manuscript for publication.

All authors read and approved the final manuscript.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

No funding was received to produce this article.