18F-FDG/18F-FES standardized uptake value ratio determined using PET predicts prognosis in uterine sarcoma

Abstract

// Makoto Yamamoto 1 , Tetsuya Tsujikawa 2 , Shizuka Yamada 1 , Tetsuji Kurokawa 2 , Akiko Shinagawa 2 , Yoko Chino 2 , Tetsuya Mori 2 , Yasushi Kiyono 2 , Hidehiko Okazawa 2 , Yoshio Yoshida 1 1 Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan 2 Biomedical Imaging Research Center, University of Fukui, Fukui, Japan Correspondence to: Yoshio Yoshida, email: yyoshida@u-fukui.ac.jp Keywords: 18 F-FES PET, 18 F-FDG PET, uterine sarcoma, prognostic prediction Received: September 30, 2016      Accepted: January 29, 2017      Published: February 06, 2017 ABSTRACT We investigated whether 16α-[ 18 F]-fluoro-17β-estradiol ( 18 F-FES) and 18 F-fluoro-deoxyglucose (FDG) uptake measured using positron emission tomography (PET) predicted prognosis in 18 patients with different histological subtypes of uterine sarcoma. Standardized uptake values (SUVs) and 18 F-FDG/ 18 F-FES SUV ratios were determined, and their correlations with progression-free (PFS) and overall survival (OS) were examined. Ten patients died from local recurrence or metastasis, and one more experienced recurrence, during the at least 36-month follow-up period. Patients with higher 18 F-FDG SUVs (> 5.5) had worse OS ( p = 0.007) and tended toward worse PFS ( p = 0.11), while patients with lower 18F-FES SUVs (≤ 1.5) had worse PFS ( p = 0.03) and tended toward worse OS ( p = 0.19). Patients with 18 F-FDG/ 18 F-FES ratios > 2.6 had worse PFS ( p = 0.009) and OS ( p = 0.005). The 5-year PFS and OS rates were 75% and 88% for patients with lower ratios, but were only 10% and 20% for those with higher ratios. These results suggest that pretreatment tumor 18 F-FDG/ 18 F-FES ratio is useful for predicting the prognosis of uterine sarcoma patients.