Predictive value of 18F-FDG accumulation in visceral fat activity to detect epithelial ovarian cancer metastases

Abstract

Relevance: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, with relapse occurring in about 70% of advanced cases with poor prognosis.

The study aimed to assess functional visceral fat activity (VAT) evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in epithelial ovarian cancer.

Methods: We assessed 53 patients with histologically confirmed EOC who underwent ¹⁸F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT was measured by maximum standardized uptake value (SUV_max) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations and pelvis cavity in the adjusted regression models. We also identifiedthe best areas under the curve (AUC) for SUV_max with the corresponding sensitivity (Se) and specificity (Sp).

Results: In both adjusted for regression models and ROC analysis, ¹⁸F-FDG accumulation in RE (cut-off SUV_max 1.18; Se 64%; Sp 64%; AUC 0.669; p = 0.035) could predict later metastases in EOC patients, as opposed to age, sex, primary tumor location, tumor grade, and histology.

Conclusions: VAT SUV_max is significantly associated with later metastases in EOC patients and can be used as their predictor.