RT Journal Article
SR Electronic
T1 The clinical usefulness of 18F-FDG PET/CT on completion of chemoradiotherapy in predicting therapeutic effect on cervix cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1851
OP 1851
VO 52
IS supplement 1
A1 Oh, Jong-Ryool
A1 Song, Ho-Chun
A1 Chong, Ari
A1 Min, Jung-Joon
A1 Bom, Hee-Seung
A1 Choi, Ho-Sun
A1 Kim, Seok-Mo
A1 Nah, Byung-Sik
A1 Yoon, Mee-Sun
YR 2011
UL http://jnm.snmjournals.org/content/52/supplement_1/1851.abstract
AB 1851 Objectives The use of 18F-FDG PET/CT (PET) immediately after radiotherapy is known to be limited because of post-irradiation effects. The objective of this study was to evaluate the clinical usefulness of 18F-FDG PET/CT on completion of chemoradiotherapy (CRT) in predicting therapeutic effect on cervix cancer. Methods Thirty-two consecutive patients (mean age: 55.8 y, range: 28 - 79 y) with locally advanced primary cervix cancer were enrolled. All patients underwent PET before, on completion of, and 3 months after CRT. Maximum standardized uptake values of uterine cervix before CRT (SUVpre), on completion of CRT (SUVcomp), after CRT (SUVpost), and the change (dSUV = SUVpre - SUVcomp) were measured. Post-irradiation effects were corrected using rectum, pelvic wall, periosteal tissue and sacrum as reference organs. Reference standards were histopathologic results and/or clinical follow-up with PET, MRI and tumor markers. Results Among 32 patients, 27 patients (84.4%) were free from tumor cells in the cervix during follow-up and 5 patients had persistent disease after CRT. In disease-free group, SUVmax of cervix was significantly decreased on completion of CRT, then it did not changed 3 months after CRT (SUVpre, SUVcomp, and SUVpost: 13.68 ± 5.84, 4.08 ± 1.24, and 3.80 ± 1.17, respectively). SUVcomp corrected with pelvic wall (SUVcomp/pelvic wall) showed the best diagnostic performance in early prediction of residual disease on completion of CRT; cut-off value > 4.34, AUC = 0.807, sensitivity: 60%, specificity: 96%, diagnostic accuracy: 91%; followed by SUVcomp/sacrum, SUVcomp, SUVcomp/periosteum, SUVcervix/rectum, and dSUV. Conclusions 18F-FDG PET was useful for early prediction of residual disease on completion of CRT in cervix cancer. SUVcomp/pelvic wall was the best parameter in this clinical setting