Prognostic utility of FDG PET/CT in advanced ovarian, fallopian and primary peritoneal high-grade serous cancer patients before and after neoadjuvant chemotherapy.

Abstract

OBJECTIVES:

In patients with advanced ovarian, fallopian and primary peritoneal carcinoma, complete interval debulking surgery (IDS) is often performed after neoadjuvant chemotherapy (NAC) to achieve long progression-free survival (PFS) and overall survival (OS). We aimed to investigate the utility of 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET/CT in patients with these malignancies who underwent complete IDS.

METHODS:

Between 2009 and 2017, twenty-two patients underwent FDG PET/CT scans before and after NAC. The highest SUVmax/peak (standardized uptake value), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) for whole lesions were defined as target SUVmax/peak, tMTV and tTLG, respectively. We also calculated these reduction rates during NAC. These parameters were compared between the groups with platinum-free interval (PFI) > 12 months (n = 10) and those with PFI ≤ 12 months (n = 12). The PFS and OS were evaluated using these quantitative parameters, and in terms of the presence of visually detectable residual lesions after NAC.

RESULTS:

The target SUVmax/peak before NAC, the reduction rates in the target SUVmax, tMTV and tTLG were significantly higher in the group with PFI > 12 months than the shorter PFI group (p < 0.05). Especially in PFS, the higher reduction rates in the target SUVmax/peak, tMTV, and tTLG had an excellent prognostic stratification (p < 0.05) and the FDG visually negative group after NAC had a significantly better prognosis than the other group (p < 0.01).

CONCLUSIONS:

The reduction rate of FDG PET-based quantitative values and visual analysis after NAC demonstrated prognostic potential, especially in PFS.

• Authors: Masao Watanabe, Yuji Nakamoto, Takayoshi Ishimori, Tsuneo Saga, Aki Kido, Junzo Hamanishi, Yasuyo Hamanaka, Kaori Togashi
• Journal: Annals of nuclear medicine (Ann Nucl Med) Vol. 34 Issue 2 Pg. 128-135 (Feb 2020) ISSN: 1864-6433 [Electronic] Japan
• PMID: 31768818 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Aged
• Female
• Fluorodeoxyglucose F18 (chemistry)
• Glycolysis (radiation effects)
• Humans
• Middle Aged
• Multimodal Imaging (methods)
• Neoadjuvant Therapy (methods)
• Ovarian Neoplasms (radiotherapy, surgery)
• Peritoneal Neoplasms (radiotherapy, surgery)
• Positron-Emission Tomography (methods)
• Prognosis
• Radiopharmaceuticals (chemistry)
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Tumor Burden (radiation effects)