University Milano-Bicocca, Milan, Italy.
Gynecol Oncol. 2012 Oct;127(1):131-5. doi: 10.1016/j.ygyno.2012.06.041. Epub 2012 Jul 6.
To evaluate the role of the metabolic characteristics of cervical tumor uptake as predictors of a) lymph node (LN) metastases, b) recurrence, in the preoperative staging of early-stage cervical cancer.
89 patients with FIGO stage IB1 and IIA<4 cm cervical cancer were imaged with FDG-PET/CT before radical hysterectomy and pelvic lymphadenectomy. PET/CT images were analyzed and correlated to histological findings. Maximum and mean standardized uptake value (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG) of cervical lesions were calculated by an iterative adaptive algorithm. These parameters were correlated to the presence of: a) LN metastases, b) relapse after primary treatment.
Out of the 89 patients who underwent preoperative PET/CT scan for staging purpose, 16 were negative at cervical level: they were all pN0 and without recurrence during follow-up (mean 34.1±14.5 months). In 69 patients MTV and TLG were significantly higher (p=0.0006 and p=0.03) in pN1 patients in comparison to pN0 patients, while SUV values did not show significant differences between the two groups. No significant correlations were found between SUVmax, SUVmean, MTV, TLG and the evidence of relapse (mean follow-up 29.2±15.5 months).
In early-stage cervical cancer MTV and TLG correlate with the presence of nodal metastases, but their clinical impact on patients management has to be clarified. The absence of pathological cervical uptake could be a good prognostic factor, while SUVmax, SUVmean, MTV, TLG of the cervical uptake have not been found predictors of recurrence.
评估宫颈肿瘤摄取的代谢特征在预测 a）淋巴结（LN）转移，b）复发方面的作用，用于早期宫颈癌的术前分期。
89 例 FIGO 分期 IB1 和 IIA<4cm 的宫颈癌患者在根治性子宫切除术和盆腔淋巴结清扫术前行 FDG-PET/CT 检查。对 PET/CT 图像进行分析，并与组织学结果相关联。通过迭代自适应算法计算宫颈病变的最大和平均标准化摄取值（SUVmax、SUVmean）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。这些参数与以下因素相关：a）LN 转移，b）原发治疗后的复发。
在 89 例行术前 PET/CT 扫描进行分期的患者中，16 例宫颈水平为阴性：他们均为 pN0，且在随访期间无复发（平均随访 34.1±14.5 个月）。在 69 例患者中，MTV 和 TLG 在 pN1 患者中明显高于 pN0 患者（p=0.0006 和 p=0.03），而 SUV 值在两组之间无显著差异。SUVmax、SUVmean、MTV 和 TLG 与复发证据之间未发现显著相关性（平均随访 29.2±15.5 个月）。
在早期宫颈癌中，MTV 和 TLG 与淋巴结转移的存在相关，但它们对患者管理的临床影响尚需阐明。宫颈摄取物的病理摄取缺失可能是一个良好的预后因素，而 SUVmax、SUVmean、MTV 和 TLG 则不是复发的预测因素。
