Predictive value of PET metabolic parameters for occult lymph node metastases in PET/CT defined node-negative patients with advanced epithelial ovarian cancer

Accurate lymph node metastasis (LNM) prediction is crucial for patients with advanced epithelial ovarian cancer (AEOC) since it guides the decisions about lymphadenectomy. Previous studies have shown that occult lymph node metastasis (OLNM) is common in AEOC. The objective of our study is to quantitatively assess the probability of occult lymph node metastasis defined by F-18-Fluorodeoxyglucose PET/CT in AEOC and explore relationship between OLNM and PET metabolic parameters. The patients with pathologically confirmed AEOC who underwent PET/CT for preoperative staging at our institute were reviewed. Univariate and multivariate analysis were performed to evaluate the predictive value of PET/CT-related metabolic parameters for OLNM. The result of our study showed metastatic TLG index had a better diagnostic performance than other PET/CT-related metabolic parameters. Two variables were independently and significantly associated with OLNM in multivariate analysis: metastatic TLG index and primary tumor location. The logistic model combining metastatic TLG index, primary tumor location, and CA125 might be a promising tool to effectively predict the individualized possibility of OLNM for AEOC patients.

Automated summary

The objective of this study was to quantitatively assess the probability of occult lymph node metastasis in AEOC defined by F-18-Fluorodeoxyglucose PET/CT and explore the relationship between OLNM and PET metabolic parameters. The results showed that the metastatic TLG index had a better diagnostic performance than other PET/CT-related metabolic parameters. Multivariate analysis identified the metastatic TLG index and primary tumor location as independent and significant factors associated with OLNM. The logistic model combining the metastatic TLG index, primary tumor location, and CA125 could effectively predict the individualized possibility of OLNM for AEOC patients.