18F-fluoro-2-deoxy-D-glucose positron emission tomography standard uptake value ratio as an indicator of cervical cancer chemoradiation therapeutic response

Abstract

Hypothesis: A ratio of 3 months of posttherapy to pretherapy 2-[ 18F]fluoro-2-deoxy-Dglucose positron emission tomography with computed tomography (18F-FDG PET/CT) standard uptake values (SUVs) predicts progression-free survival after chemoradiation in patients with stages IB2 to IVA cervical cancer. Methods: This retrospective review included 51 patients who received treatments of daily pelvic radiation and once-weekly cisplatin chemotherapy followed by brachytherapy. Posttherapy confirmatory surgical or cytologic pathology was done a median of 7 days after 3-month 18F-FDG PET/CT. Results: All 51 patients receiving chemoradiation achieved at least a partial metabolic response (ie, <25% decrease in 18F-FDG PET/CT SUV) in the expected region of the cervix. A ratio of less than 0.33 for posttherapy to pretherapy 18F-FDG PET/CT SUVs of the expected area of the cervix was associated with a 35% improvement in 6-month progressionfree survival. Conclusions: In patients with cervical cancer, the 3-month posttherapy 18F-FDG PET/CT value is an indicator of therapeutic response to chemoradiation and needs further validation in clinical trials. © 2011 by IGCS and ESGO.