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Predictive value of SUVmax from initial 18F-FDG PET/CT scans for treatment outcomes in endometrial cancer patients undergoing fertility sparing management
  1. Ok-Ju Kang1,
  2. Yonghee Park1,
  3. Eun Min Lee1,
  4. Jong Jin Lee2,
  5. Shin-Wha Lee1,
  6. Dae-Yeon Kim1,
  7. Dae-Shik Suh1,
  8. Jong-Hyeok Kim1,
  9. Yong-Man Kim1 and
  10. Jeong-Yeol Park1
    1. 1Department of Obstetrics and Gynecology, Asan Medical Center, Songpa-gu, Seoul, Korea
    2. 2Department of Nuclear Medicine, Asan Medical Center, Songpa-gu, Seoul, Korea
    1. Correspondence to Dr Jeong-Yeol Park, Department of Obstetrics and Gynecology, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Korea; catgut1-0{at}


    Objective To evaluate whether the maximum standardized uptake value (SUVmax) from initial 18F-FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography) scans could be a predictor of complete response and recurrence in patients with endometrial cancer who are undergoing fertility sparing management.

    Methods We conducted a retrospective review of patients who were diagnosed with endometrial cancer through biopsy and chose to undergo fertility sparing management using progestin at the Asan Medical Center, from January 2011 to December 2020. Of these, 113 patients who had an 18-FDG-PET/CT scan before starting treatment were included in our study. We measured SUVmax and examined its correlation with complete response and time to progression after achieving complete response to progestin therapy.

    Results Of 113 patients, 73 (64.6%) achieved a complete response through fertility sparing management. The receiver operating characteristic curve analysis revealed that the optimal cut-off value of SUVmax for predicting complete response was 6.2 (sensitivity 79.5%, specificity 57.5%, p=0.006). After analyzing recurrence in the 73 patients who achieved complete response, we found that patients with an SUVmax value >6.2 had a significantly shorter time to progression compared with those with a value <6.2. (p=0.04).

    Conclusions SUVmax values of PET-CT, along with other clinicopathological parameters, could be used to predict treatment response and recurrence risk in patients with stage I endometrial cancer undergoing fertility sparing management.

    • Uterine Cancer

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    • Contributors Author responsible for the overall content as the guarantor: P- JY. Concept and design: K- OJ, P- JY. Acquisition, analysis, or interpretation of data: K- OJ, YP, EML, JJL, L- SW, K- DY, S- DS, K- JH, K- YM, P- JY. Drafting of the manuscript: K- OJ, P- JY. Critical revision of the manuscript for important intellectual content: K- OJ, P- JY. Statistical analysis: K- OJ. Administrative, technical, or material support: L- SW, K- DY, S- DS, K- JH, K- YM. Supervision: JJL.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.