Prognostic value of metabolic tumor volume measured by FDG-PET/CT in patients with cervical cancer

Hyun Hoon Chung, Jae Weon Kim, Kyung Hee Han, Jae Seon Eo, Keon Wook Kang, Noh Hyun Park, Yong Sang Song, June Key Chung, Soon Beom Kang

Research output: Contribution to journalArticlepeer-review

117 Citations (Scopus)


Objective: To determine if preoperative metabolic tumor volume (MTV) measured by integrated 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (FDG-PET/CT) imaging has prognostic value in patients with cervical cancer treated primarily with radical hysterectomy. Methods: Patients with FIGO stage IB to IIA cervical cancer were imaged with FDG-PET/CT before radical surgery. MTV was measured from attenuation-corrected FDG-PET/CT images using a standard uptake value (SUV)-based automated contouring program. We evaluated the relationship of MTV to disease-free survival (DFS). Results: A total of 63 patients were included in the study. The cut-off value for predicting recurrence was determined using a receiver operating characteristic (ROC) curve. MTV in this study was found to be correlated with lymph node (LN) metastasis, parametrium (PM) involvement, FIGO stage, and SUVmax. In univariate analysis, MTV ≥ 23.4 mL (HR 1.017, 95% confidence interval (CI) 1.005-1.029, P = 0.004), SUVmax ≥ 9.5 (HR 5.198, 95% CI 1.076-25.118, P = 0.04), LN metastasis (HR 12.338, 95% CI 1.541-98.813, P = 0.018), PM involvement (HR 14.274, 95% CI 1.785-114.149, P = 0.012), and lymphovascular space invasion (HR 8.871, 95% CI 1.104-71.261, P = 0.04), were related to DFS. In multivariate analyses, age (HR 0.748, 95% CI 0.587-0.952, P = 0.018) and MTV ≥ 23.4 mL (HR 49.559, 95% CI 1.257-1953.399, P = 0.037) were determined to be independent prognostic factors of DFS. Conclusion: Preoperative MTV is an independent prognostic factor for DFS in patients with cervical cancer treated by radical surgery.

Original languageEnglish
Pages (from-to)270-274
Number of pages5
JournalGynecologic Oncology
Issue number2
Publication statusPublished - 2011 Feb
Externally publishedYes


  • Cervical cancer
  • Metabolic tumor volume
  • PET/CT
  • Recurrence
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology


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