Department of Nuclear Medicine, University of Pretoria, Pretoria, South Africa.
Biostatistics Unit, South African Medical Research Council, Pretoria, South Africa.
PLoS One. 2019 Apr 18;14(4):e0215412. doi: 10.1371/journal.pone.0215412. eCollection 2019.
To determine the impact of FDG-PET/CT in the initial staging of cervical cancer among women with and without HIV and to determine the abilities of FDG-PET/CT metabolic parameters in predicting the presence of distant metastasis.
We reviewed the FDG-PET/CT images of women with FIGO stage IB2 to IVA carcinoma of the cervix. We compared the FIGO stage before and after FDG-PET/CT. Maximum and mean standardized uptake values (SUVmax and SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion were determined. We compared these parameters between the HIV-infected and uninfected woman and also determined their abilities to predict the presence of distant metastasis.
126 women, mean age 48.05 ± 11.80 years were studied. Seventy-three patients were HIV-infected. The disease was upstaged in 65 patients, 32 of which were upstaged to stage IVB. HIV-infected women were younger (43.36 ± 8.03 years versus 54.51 ± 13.12, p<0.001) and had more advanced disease (p = 0.022) compared with HIV-uninfected. In a univariate logistic regression adjusted for the FIGO stage of the disease, there were significant associations between MTV and TLG of the primary tumor and distant metastasis. SUVmax, SUVmean, MTV and TLG performed well in predicting the presence of distant metastasis with areas under the curves (AUCs) of 0.63, 0.66, 0.80 and 0.77 respectively. These performances improved after adjustment for the FIGO stage of the disease with AUCs of 0.80, 0.79, 0.84 and 0.82 for SUVmax, SUVmean, MTV and TLG respectively.
Inclusion of 18F-FDG-PET/CT in the pre-therapy assessment of cervical cancer improves the accuracy of staging in about half of the patients. The metabolic parameters of the primary tumor perform well in predicting the presence of distant metastases.
确定 FDG-PET/CT 在有和没有 HIV 的宫颈癌女性初始分期中的影响，并确定 FDG-PET/CT 代谢参数在预测远处转移方面的能力。
我们回顾了 FIGO 分期为 IB2 至 IVA 期宫颈癌的女性的 FDG-PET/CT 图像。我们比较了 FDG-PET/CT 前后的 FIGO 分期。原发肿瘤的最大标准化摄取值（SUVmax 和 SUVmean）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。我们比较了 HIV 感染和未感染女性之间的这些参数，并确定了它们预测远处转移的能力。
研究了 126 名平均年龄为 48.05 ± 11.80 岁的女性。73 名患者为 HIV 感染。65 名患者的疾病分期升高，其中 32 名患者分期升高至 IVB 期。与 HIV 未感染的患者相比，HIV 感染的女性更年轻（43.36 ± 8.03 岁比 54.51 ± 13.12 岁，p<0.001）且疾病更晚期（p=0.022）。在调整疾病的 FIGO 分期的单变量逻辑回归中，原发肿瘤的 MTV 和 TLG 与远处转移之间存在显著关联。SUVmax、SUVmean、MTV 和 TLG 在预测远处转移方面表现良好，曲线下面积（AUCs）分别为 0.63、0.66、0.80 和 0.77。这些性能在调整疾病的 FIGO 分期后得到改善，SUVmax、SUVmean、MTV 和 TLG 的 AUC 分别为 0.80、0.79、0.84 和 0.82。
在宫颈癌的治疗前评估中纳入 18F-FDG-PET/CT 可将约一半患者的分期准确性提高。原发肿瘤的代谢参数在预测远处转移方面表现良好。
