Cervical cancer evaluated with integrated 18F-FDG PET/MR

Jing Gong; Nan Wang; Lihua Bian; Min Wang; Mingxia Ye; Na Wen; Meng Fu; Wensheng Fan; Yuanguang Meng

doi:10.3892/ol.2019.10514

Cervical cancer evaluated with integrated ¹⁸F-FDG PET/MR

Oncol Lett. 2019 Aug;18(2):1815-1823. doi: 10.3892/ol.2019.10514. Epub 2019 Jun 21.

Authors

Jing Gong^{1

2}, Nan Wang¹, Lihua Bian¹, Min Wang¹, Mingxia Ye¹, Na Wen¹, Meng Fu³, Wensheng Fan¹, Yuanguang Meng¹

Affiliations

¹ Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing 100853, P.R. China.
² Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.
³ Department of Obstetrics and Gynecology, Haidian Maternal and Child Health Hospital, Beijing 100080, P.R. China.

Abstract

The current study aimed to evaluate the correlation between maximum standardized uptake value (SUV_max) and minimum apparent diffusion coefficient (ADC_min) of cervical cancer using an integrated ¹⁸F-fluorodeoxyglucose positron emission tomography/magnetic resonance (PET/MR) imaging system, and to determine the association with pathological prognostic factors. A total of 46 patients were pathologically diagnosed with cervical cancer and underwent PET/MR prior to surgery, including total hysterectomy, bilateral pelvic lymph node dissection or paraaortic lymph node dissection. The imaging biomarkers included the SUV_max and ADC_min. The pathological prognostic factors were as follows: Tumor size, histological grade, International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis. Pearson's correlation analysis was used to evaluate the correlation between imaging biomarkers and the tumor size and the Mann-Whitney U test analysis was used to evaluate the association between imaging biomarkers and pathological factors. The mean SUV_max was 11.1±8.7 (range, 3.16-51.6) and the mean ADC_min was 0.76±0.15×10^-3 mm²/s (range, 0.47-1.04×10^-3 mm²/s). The SUV_max had a significant negative correlation with the ADC_min (r=-0.700; P<0.001). The SUV_max was significantly increased in patients with poorly differentiated tumors (P=0.001), patients with FIGO stage IIB (P=0.005) and the patients with lymph node metastasis (P=0.040). The ADC_min was significantly decreased in patients with poorly differentiated tumors (P<0.001) and patients with FIGO stage IIB (P=0.017). Statistical analysis revealed no significant correlation between the tumor size and the SUV_max (r=0.286;P=0.054), or between the tumor size and the ADC_min (r=-0.231; P=0.122). Area under the curve (AUC) analysis revealed that SUV_max had a higher diagnostic value for lymph node metastasis (AUC=0.681) and FIGO staging (AUC=0.837) compared with ADC_min, whereas ADC_min had a higher diagnostic value for the grade of pathological differentiation (AUC=0.816) compared with SUV_max (AUC=0.788). The results of the current study demonstrated that there was a significant negative correlation between SUV_max and ADC_min, which were associated with prognostic factors.

Keywords: International Federation of Gynecology and Obstetrics stage; cervical cancer; histological grade; lymph node metastasis; maximum standardized uptake value; minimum apparent diffusion coefficient; positron emission tomography/magnetic resonance imaging.