Correlation between standardized uptake value and intravoxel incoherent motion parameters of cervical squamous cell carcinoma with 18F-FDG PET/MR

Abstract

Objective To assess the correlation between standardized uptake value (SUV) and intravoxel incoherent motion (IVIM) parameters of primary cervical squamous cell carcinoma (CSCC) and pelvic metastatic lymph nodes in the use of hybrid PET/MR. Methods Forty-six CSCC patients in Shengjing Hospital from January 2015 to December 2015 were prospectively enrolled and divided into well-differentiated (G1) group, moderate-differentiated (G2) group and poorly-differentiated (G3) group. PET/MR examination with the multi-b-value diffusion-weighted imaging (DWI) sequence was performed before treatment. Maximum SUV (SUVmax) and mean SUV (SUVmean) were calculated. IVIM parameters, including the slow diffusion coefficient (D), fast diffusion coefficient (D*), perfusion fraction (f) were also measured. Pearson correlation analysis was used to evaluate the correlation between IVIM parameters and SUV(SUVmax, SUVmean). Results The D of G1, G2, G3 lesions and metastatic lymph nodes were (0.827±0.232)×10-3, (0.640±0.153)×10-3, (0.563±0.090)×10-3 and (0.772±0.246)×10-3 mm2/s respectively. The f was 0.310±0.068, 0.348±0.073, 0.287±0.057 and 0.413±0.103 respectively. The D* was (9.241±2.001)×10-3, (9.408±1.927)×10-3, (9.715±1.827)×10-3 and (8.830±1.632)×10-3 mm2/s respectively. The SUVmax was 9.988±3.806, 12.941±5.990, 14.543±7.050 and 9.890±3.906 respectively. The SUVmean was 5.717±2.830, 7.094±3.518, 8.263±4.124 and 4.952±1.343 respectively. The D of G1 and G2 lesions had negative correlations with SUVmax and SUVmean (G1, r values: -0.816, -0.842; G2, r values: -0.528, -0.559; all P<0.05); the f of G2 lesions had positive correlations with SUVmax and SUVmean (r values: 0.554, 0.550, both P<0.05). Conclusions The SUVmax and SUVmean of the well-moderate differentiated CSCC are consistent with D and f, which reflect the cell density and the microvascular perfusion. PET/MR-IVIM could provide important complementary information for treatment-monitoring and prognostic assessment of patients with cervical cancer. Key words: Uterine cervical neoplasms; Carcinoma, squamous cell; Positron-emission tomography; Magnetic resonance imaging; Deoxyglucose