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Abstract
Objective: To evaluate whether textural features obtained from F-18 FDG PET/CT offer clinical value that can predict the outcome of patients with locally advanced cervical cancer (LACC) receiving concurrent chemoradiotherapy (CCRT).

Methods: We reviewed the records of 68 patients with stage IIB-IVA LACC who underwent PET/CT before CCRT. Conventional metabolic parameters, shape indices, and textural features of the primary tumor were measured on PET/CT. A Cox regression model was used to examine the effects of variables on overall survival (OS) and progression-free survival (PFS).

Results: The patients included in this study were classified into two groups based on median value of PET/CT parameters. The high group of GLNU derived from GLRLM is only independent prognostic factor for PFS (HR 7.142; 95% CI 1.656-30.802; p = 0.008) and OS (HR 9,780; 95% CI 1.222-78.286; p = 0.031). In addition, GLNU derived from GLRLM (AUC 0.846, 95% CI 0.738-0.923) was the best predictor for recurrence among clinical prognostic factors and PET/CT parameters.

Conclusion: Our results demonstrated that high GLNU from GLRLM on pretreatment F-18 FDG PET/CT images, were significant prognostic factors for recurrence and death in patients with LACC receiving CCRT.

Affiliations

Hyun-Woong Cho # 1, Eun Seong Lee # 2, Jae Kwan Lee 1, Jae Seon Eo 3, Sungeun Kim 4, Jin Hwa Hong 5
1Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
2Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea.
3Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea. jaeseon76@gmail.com.
4Department of Nuclear Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
5Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-Ro, Guro-Gu, Seoul, 08308, Republic of Korea. jhhong93@korea.ac.kr.
#Contributed equally.