Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2016 , Vol 7, Issue 3
Correlation Between Pet/ct Primary Tumor Fdg Uptake Levels and Lymph Node Metastases In Patients With Cervical Cancer
Gamze Uğurluer1, Banu Atalar2, Hayriye Aslı Saran İkizler3, Nihat Sözer3, Mustafa Kibar4, Meltem Serin1, Enis Özyar2
1Acıbadem Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Acıbadem Adana Hastanesi, Adana, Türkiye
2Acıbadem Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Acıbadem Maslak Hastanesi, İstanbul, Türkiye
3Acıbadem Bursa Hastanesi, Radyasyon Onkolojisi Kliniği, Bursa, Türkiye 4Acıbadem Adana Hastanesi, Nükleer Tıp Kliniği; Çukurova Üniversitesi, Nükleer Tıp Anabilim Dalı, Adana, Türkiye
Objectives: The aim of this study was to determine the correlation between Positron Emission Tomography/Computed Tomography (PET/CT) primary tumor FDG uptake levels and lymph node metastases in cervical cancer patients.

Materials and methods: One hundred and three (103) cervical cancer patients who had pretreatment staging PET/CT were included in the study. Primary tumor maximum standard uptake value (SUVmax) levels, maximum tumor diameter measured on PET/CT, FDGavid pelvic and paraaortic lymph nodes and SUVmax values for FDG-avid lymph nodes were recorded for every patient. Correlation between SUVmax levels and lymph node metastases were evaluated. Statistical analysis was done using SPSS.

Results: Median age was 56 years (range 31-91 years). Mean SUVmax levels for primary tumor and for lymph nodes were 14,3±6,3 (range; 3,9-34,2) and 8,6±3,9 (range; 2,8-19,3), respectively. SUVmax levels for the patients with FDG-avid lymph nodes and non FDG-avid patients were 15,9 (range; 4,1-34,2) and11,9 (range; 3,9-25,5) (p <0,05). Mean levels for the low and the high SUVmax groups (according to the median SUVMax level, 13,9) were 9,3 (range; 3,9-13,4) and 18,9 (range; 13,9-34,2). There were lymph node metastases in 46% of patients in the low SUVmax group and in 70% of patients in the high SUVmax groups (p <0,05). The mean SUVmax levels in patients with tumor's diameter ≤4 cm and >4 cm were 13,1 (range; 5,5-25,5) and 17,1 (range; 7,7-34,2), respectively. In 42% of patients with tumor diameter ≤4 cm and 66% of patients with tumor diameter >4 cm there were lymph node metastases. Two groups were statistically different according to the SUVmax levels and lymph node metastases (p <0,05).

Conclusion: SUVmax levels in cervical cancer patients might be correlated to elevated risk of developing lymph node metastases and might change the prognosis of patients and the treatment approach. Keywords : cervical cancer, PET/CT, SUVmax, lymph node metastases