Jenny Aase Husby MD, Presenter: Nothing to Disclose

Bernt Christian Reitan MD, Abstract Co-Author: Nothing to Disclose

Jone Trovik MD, Abstract Co-Author: Nothing to Disclose

Oyvind Salvesen, Abstract Co-Author: Nothing to Disclose

Martin Biermann PhD, Abstract Co-Author: Nothing to Disclose

Helga Salvesen MD, PhD, Abstract Co-Author: Nothing to Disclose

Ingfrid S. Haldorsen MD, PhD, Abstract Co-Author: Nothing to Disclose

Explore the value of metabolic tumor volume assessment on 18F-fluorodeoxyglucose Positron Emission Tomography / Computer Tomography (18-FDG-PET/CT) in the preoperative evaluation of endometrial carcinoma patients and explore the potential for prediction of outcome by this quantity.

In this prospective study, 104 consecutive patients with histologically confirmed endometrial carcinoma underwent preoperative FDG-PET/CT. The images were reviewed by a radiologist / nuclear medicine physician blinded to patient data, and metabolic tumor volume was calculated by placing a volume of interest (VOI) covering the portion of tumor with SUVmax > 2.5. Metabolic tumor volume was analyzed in relation to surgical staging parameters using logistic regression analysis and receiver operating characteristic (ROC) curves. The prognostic impact of metabolic tumor volume was explored using Kaplan-Meier method, log rank test and Cox regression analysis.

Large metabolic tumor volume was significantly related to presence of deep myometrial invasion (odds ratio (OR): 1.02, p=0.01) and presence of lymph node metastases (OR: 1.02, p=0.05). Metabolic tumor volume had a significant impact on recurrence-free survival with a hazard ratio of 1.014 (p<0.001). ROC analysis identified the optimal cutoff for metabolic tumor volume to be 18.1 ml. Significantly better recurrence-free survival was observed in patients with metabolic tumor volume ≥ 18.1 ml compared to patients with volume < 18.1 ml (p=0.004).

Preoperatively performed metabolic tumor volume measurements on FDG-PET/CT predict deep myometrial invasion, presence of lymph node metastases and prognosis in endometrial carcinoma patients, and may thus be a useful tool in risk stratification and decision-making prior to surgical and adjuvant treatment.

Metabolic tumor volume measurements on FDG-PET/CT can aid in the prediction of deep myometrial invasion, presence of lymph node metastases and outcome in endometrial carcinoma patients, and thus be an important tool for preoperative risk stratification and choice of treatment.

Husby, J, Reitan, B, Trovik, J, Salvesen, O, Biermann, M, Salvesen, H, Haldorsen, I, Metabolic Tumor Volume on FDG-PET/CT Predicts Deep Myometrial Invasion, Lymph Node Metastases and Survival in Patients with Endometrial Carcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016975.html