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Monitoring the neoadjuvant therapy response in gynecological cancer patients using FDG PET

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

We retrospectively evaluated the ability of FDG PET to predict the response of primary tumor to chemotherapy or chemoradiotherapy in patients with gynecological cancer.

Methods

FDG PET examinations were performed before and after completion of chemotherapy or chemoradiotherapy in 21 patients with advanced gynecological cancer (uterine cancer, n = 13; ovarian cancer, n = 8). PET imaging was performed at 1 h after injection. Semi-quantitative analysis was performed using the standardized uptake value (SUV) at the primary tumor for both before and after therapy (SUVbefore and SUVafter, respectively). Percent change value was calculated according to the following equation: \( {{\left( {SUV_{{{\text{before}}}} - SUV_{{{\text{after}}}} } \right)} \times 100} \mathord{\left/ {\vphantom {{{\left( {SUV_{{{\text{before}}}} - SUV_{{{\text{after}}}} } \right)} \times 100} {SUV_{{{\text{before}}}} }}} \right. \kern-\nulldelimiterspace} {SUV_{{{\text{before}}}} } \). Based on histopathological analysis of the specimens obtained at surgery, patients were classified as responders or non-responders.

Results

Ten patients were found to be responders and 11 to be non-responders. SUVafter in responders was significantly lower than that in non-responders (p < 0.005). Taking an arbitrary SUVafter of 3.8 as the cutoff for differentiating between responders and non-responders, FDG PET showed a sensitivity of 90%, a specificity of 63.6%, and an accuracy of 76.2%. The percent change value in the responders was significantly higher than that in the non-responders (p < 0.0005). Taking an arbitrary percent change of 65 as the cutoff for differentiating between responders and non-responders, FDG PET showed a sensitivity of 90%, a specificity of 81.8%, and an accuracy of 85.7%.

Conclusion

These findings suggest that FDG PET-derived parameters including SUV and especially percent change value may have the potential to predict response to chemotherapy or chemoradiotherapy in patients with advanced gynecological cancer.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Yoshihiro Nishiyama, Yuka Yamamoto & Motoomi Ohkawa

  2. Department of Perinatology and Gynecology, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Kenji Kanenishi, Masami Ohno & Toshiyuki Hata

  3. Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Yoshio Kushida & Reiji Haba

Authors
  1. Yoshihiro Nishiyama
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  2. Yuka Yamamoto
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  3. Kenji Kanenishi
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  4. Masami Ohno
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  5. Toshiyuki Hata
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  6. Yoshio Kushida
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  7. Reiji Haba
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  8. Motoomi Ohkawa
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Correspondence to Yoshihiro Nishiyama.

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Nishiyama, Y., Yamamoto, Y., Kanenishi, K. et al. Monitoring the neoadjuvant therapy response in gynecological cancer patients using FDG PET. Eur J Nucl Med Mol Imaging 35, 287–295 (2008). https://doi.org/10.1007/s00259-007-0627-7

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  • DOI: https://doi.org/10.1007/s00259-007-0627-7

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