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Meeting ReportOncology, Clinical Science Track

Advanced cervical cancer and neoadjuvant treatment: predictive role of 18F-FDG PET/CT for treatment response

Paola Mapelli, Elena Incerti, Federico Fallanca, Alice Bergamini, Andrea Dell'Acqua, Emanuela Rabaiotti, Micaela Petrone, Massimo Candiani, Luigi Gianolli and Maria Picchio
Journal of Nuclear Medicine May 2016, 57 (supplement 2) 1530;
Paola Mapelli
1Nuclear Medicine IRCCS San Raffaele Scientific Institute Milan Italy
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Elena Incerti
1Nuclear Medicine IRCCS San Raffaele Scientific Institute Milan Italy
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Federico Fallanca
1Nuclear Medicine IRCCS San Raffaele Scientific Institute Milan Italy
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Alice Bergamini
2Obstetrics and Gynecology IRCCS San Raffaele Scientific Institute Milan Italy
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Andrea Dell'Acqua
2Obstetrics and Gynecology IRCCS San Raffaele Scientific Institute Milan Italy
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Emanuela Rabaiotti
2Obstetrics and Gynecology IRCCS San Raffaele Scientific Institute Milan Italy
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Micaela Petrone
2Obstetrics and Gynecology IRCCS San Raffaele Scientific Institute Milan Italy
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Massimo Candiani
2Obstetrics and Gynecology IRCCS San Raffaele Scientific Institute Milan Italy
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Luigi Gianolli
1Nuclear Medicine IRCCS San Raffaele Scientific Institute Milan Italy
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Maria Picchio
1Nuclear Medicine IRCCS San Raffaele Scientific Institute Milan Italy
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Abstract

1530

Objectives To evaluate the predictive role of 18F-FDG PET/CT in predicting response to neoadjuvant treatment in patients with advanced cervical cancer (CC).

Methods This study retrospectively included 13 women with CC who underwent to 18F-FDG PET/CT before and after neoadjuvant treatment (chemotherapy n=10; chemoradiotherapy n=3). Baseline and post-treatment PET-derived parameters (maximum standardized uptake value-SUVmax and metabolic tumour volume with a threshold of 60-MTV60) of the primary tumors have been performed to assess treatment response and predictive value. Two-tailed t-test was used to assess the differences between PET parameters.

Results The median age at the time of baseline 18F-FDG PET/CT was 52 years (range: 36-91); the median time interval between baseline and post neoadjuvant treatment scans was 3.6 months (range: 1.8-7.9). Comparing baseline and post-treatment scans, 7/13 patients showed response to therapy and 6/13 patients had stable disease or progressive disease. The mean and median SUVmax of the primary tumour were 16.9 and 12.7 (range 3.7-35.5) and 11.3 and 7.5 (range 2.8-4.1) for the baseline and post-treatment scan, respectively. The mean percentage change in SUVmax between baseline and post treatment scan was 44.8% (range: 5.9 - 79.4%) and -2.8% (range: -102.7 - 74.1%) in responders and non-responders, respectively. Interestingly, baseline mean and median SUVmax of the primary tumor were higher (21.5 and 19.2; range: 3.7-35.5) in non-responders or progression after treatment compared to responders (13.0 and 11.7; range: 8.3-25.3). The mean and median MTV60 of the primary tumor were 11.5 and 7.16 (range 1.8-56.5) and 6.4 and 3.1 (range 0.8-34.8) for the baseline and post-treatment scan, respectively. The average percentage change in MTV60 between baseline and post treatment scan was 39.3% (range: -85.9 - 98.6%) and -75.7% (range: -454.5- 91.0%) in responders and non-responders, respectively. Strikingly, baseline mean and median MTV60 of the primary tumor were lower (6.8 and 4.8; range: 1.8-15.2) in non-responders or progression after neoadjuvant treatment compared responders to treatment (15.7 and 8.9; range: 5.2-56.5), although not reaching statistical significance.

Conclusions Although these study included only a small cohort of patients with advanced CC, the strong differences between SUVmax, MTV60 and their variation between baseline and post-treatment scans in responders and non-responders may be relevant for patients’ treatment decision-making.

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Journal of Nuclear Medicine
Vol. 57, Issue supplement 2
May 1, 2016
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Advanced cervical cancer and neoadjuvant treatment: predictive role of 18F-FDG PET/CT for treatment response
Paola Mapelli, Elena Incerti, Federico Fallanca, Alice Bergamini, Andrea Dell'Acqua, Emanuela Rabaiotti, Micaela Petrone, Massimo Candiani, Luigi Gianolli, Maria Picchio
Journal of Nuclear Medicine May 2016, 57 (supplement 2) 1530;

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Advanced cervical cancer and neoadjuvant treatment: predictive role of 18F-FDG PET/CT for treatment response
Paola Mapelli, Elena Incerti, Federico Fallanca, Alice Bergamini, Andrea Dell'Acqua, Emanuela Rabaiotti, Micaela Petrone, Massimo Candiani, Luigi Gianolli, Maria Picchio
Journal of Nuclear Medicine May 2016, 57 (supplement 2) 1530;
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