Gynecological Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_16_3479 - Association of 18F-FDG-PET SUV and tumor size in cervical cancer.

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Association of 18F-FDG-PET SUV and tumor size in cervical cancer.
A. G. Paul1,2, L. K. Heilbrun3,4, D. W. Smith3,4, and S. R. Miller II4; 1Detroit Medical Center, Detroit, MI, 2University of Alabama, Birmingham, AL, 3Karmanos Cancer Institute, Detroit, MI, 4Wayne State University School of Medicine, Detroit, MI

Purpose/Objective(s): Cervical cancer is the fourth most common cancer among women globally with 528,000 new cases and 266,000 cancer-related deaths in 2012. Delineation of the biological heterogeneity and consequent prognostic stratification of cervical cancer is an active area of investigation. 18F-FDG-PET associated standard uptake value (SUV) and tumor size are independent prognostic factors in cervical cancer. However, an association between SUV and tumor size is unknown. In this study, we investigated hypothesized associations between age, tumor size, and SUV in cervical cancer patients.

Materials/Methods: 124 patients with locally advanced cervical cancer treated from January 2008 to July 2015 with concurrent chemotherapy and radiation were retrospectively screened for the study. The inclusion criteria for the study were: a) pre-EBRT PET and MRI acquired for estimating initial tumor size (GTVi); and b) absence of metastatic disease. GTVi was contoured on the respective MRI. SUV for each PET scan was collected from radiology reports. Spearman's rank correlation coefficient (rho) values were calculated to assess the relationships among age, tumor size, and SUV.

Results: 48 patients met the inclusion criteria of the study with a median age of 50 years (range; 22 – 85). The median GTVi was 82cc (range; 7.7 – 818). The median SUV was 14.9 (range; 4.3 – 27.5). 88% of the patients had squamous cell carcinoma. 6% and 4% of the patients had adenocarcinoma and adeno-squamous carcinoma, respectively with 1 patient having cervical intra-epithelial neoplasia with microinvasion. A significant correlation was seen between SUV and GTVi with higher SUV associated with larger tumor size (Table 1). No significant association was observed between either SUV and age or age and GTVi (Table 1). 16% and 18% of the patients had pelvic and distant recurrences, respectively after a median follow up of 23.9 months (range; 0.5 - 79). Table 1: Spearman rank correlation (Rho) statistics
Variable With variable Sample correlation 95% confidence interval
SUV Age 0.05 -0.24 - 0.33
SUV GTVi 0.31 0.03 - 0.54
Age GTVi 0.13 -0.16 - 0.40

Conclusion: For the first time our study suggests a positive correlation between 18F-FDG-PET SUV and tumor size in cervical cancer. Biologically, larger cervical tumors are proposed to be more metabolically active and might be the underlying reason behind higher SUVs. Further work is underway to investigate potential associations between either tumor size or SUV with tumor response.

Author Disclosure: A.G. Paul: None. L.K. Heilbrun: None. D.W. Smith: None. S.R. Miller: None.

Arun Paul, MD, PhD

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