E-ISSN: 2791-8823
Cam & Sakura Medical Journal
Diagnostic Accuracy of Preoperative Metabolic 18F-FDG PET/CT Parameters for Patients with Endometrial Cancer Treated with Postoperative Radiation Therapy [Cam Sakura Med J]
Cam Sakura Med J. 2021; 1(1): 14-23 | DOI: 10.4274/csmedj.galenos.2021.2021-8-9

Diagnostic Accuracy of Preoperative Metabolic 18F-FDG PET/CT Parameters for Patients with Endometrial Cancer Treated with Postoperative Radiation Therapy

Sedef Da1, Aye Kutluhan Doan2, Emel Canaz2, Nazmiye Deniz Arslan1, Burak Ylmaz3
1University of Health Sciences Turkey, Yedikule Chest Disease and Toracic Surgery Training and Research Hospital, Clinic of Radiation Oncology, stanbul, Turkey
2University of Health Sciences Turkey, Baakehir am and Sakura City Hospital, Clinic of Gynecologic Oncology, stanbul, Turkey
3University of Health Sciences Turkey, Baakehir am and Sakura City Hospital, Clinic of Nuclear Medicine, stanbul, Turkey

Objective: This study aimed to evaluate the diagnostic accuracy of preoperative 18F-fluorodeoxy- glucose (FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters for the prediction of risk factors and detection of lymph node metastasis (LNM) in patients with endometrial cancer.
Material and Methods: This study included 26 patients with endometrioid carcinoma who underwent preoperative PET/CT and treated with adjuvant local radiotherapy. The maximum standard uptake value of the tumor (SUVmax-T), SUVmax of the pelvic and/or para-aortic LNs, metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) with cut-off values of 30-40% were calculated. International Federation of Gynecology and Obstetrics stages 3 and 4, highgrade disease, lymphovascular invasion (LVI), cervical involvement (CI), and myometrial invasion (MI) ≥50% were established as high-risk features. Disease-free survival and overall survival were analyzed in comparison with 18F-FDG PET/CT parameters.
Results: SUVmax-T was only associated with tumor diameter (p=0.01). It was not correlated with MI, high-grade disease, CI, or LNM. With SUVmax-P ≥2.81 as a cut-off value, the sensitivity, specificity, and accuracy in the detection of LNM were high (90%, 83.3%, 71.4%, respectively). For LNM, the mean MTV-30 (p=0.021), TLG-30 (p=0.030), and SUVmax-P (p=0.009) were significant predictors. According to the regression analysis, MTV-40 (p=0.043) was an independent predictor of LNM, and LVI (p=0.037) was the only significant predictor of MI. MTV-30 was a significant predictor of CI (p=0.04).
Conclusion: SUVmax-P, MTV, and TLG cut-off values, to predict LN metastases, increase diagnostic accuracy for EC.

Keywords: Brachytherapy, endometrial cancer, FDG-PET/CT, metabolic parameters

Sedef Da, Aye Kutluhan Doan, Emel Canaz, Nazmiye Deniz Arslan, Burak Ylmaz. Diagnostic Accuracy of Preoperative Metabolic 18F-FDG PET/CT Parameters for Patients with Endometrial Cancer Treated with Postoperative Radiation Therapy. Cam Sakura Med J. 2021; 1(1): 14-23

Corresponding Author: Sedef Da, Trkiye
Manuscript Language: English
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