Cervical cancer histology and tumor differentiation affect ¹⁸F‐fluorodeoxyglucose uptake

<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>This study aimed to evaluate the variation in cervical cancer glucose metabolism for different tumor histologies and levels of differentiation, as measured by the uptake of <jats:sup>18</jats:sup>F‐fluorodeoxyglucose (FDG) by positron emission tomography (PET).</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>The study population consisted of 240 patients with International Federation of Gynecology and Obstetrics stages Ib1 through IVb cervical cancer, who underwent a pretreatment FDG‐PET. Tumor histology included 221 squamous cell (SC), 4 adenosquamous (AS), and 15 adenocarcinoma (AC) tumors. There were 14 well, 145 moderately, and 81 poorly differentiated tumors. The stage distribution was as follows: 70 stage I tumors (9 AC, 2 AS, and 59 SC), 102 stage II tumors (3 AC, 1 AS, and 98 SC), 64 stage III tumors (3 AC, 1 AS, and 60 SC), and 4 stage IV tumors (4 SC). From the FDG‐PET, maximal standardized uptake value (SUV<jats:sub>max</jats:sub>) was determined. The variation in SUV<jats:sub>max</jats:sub> was analyzed for differences based on tumor histology and differentiation.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>For all patients, the mean SUV<jats:sub>max</jats:sub> was 11.62 (range, 2.50‐50.39). The mean SUV<jats:sub>max</jats:sub> by histology was as follows: SC, 11.91 (range, 2.50‐50.39); AS, 8.85 (range, 6.53‐11.26); and AC, 8.05 (range, 2.83‐13.92). Squamous versus nonsquamous tumors demonstrated a significant difference in SUV<jats:sub>max</jats:sub> (<jats:italic>P</jats:italic> = .0153). SUV<jats:sub>max</jats:sub> and tumor volume were not found to be correlated (<jats:italic>R</jats:italic><jats:sup>2</jats:sup> = 0.013). The mean SUV<jats:sub>max</jats:sub> was 8.58 for well‐differentiated, 11.56 for moderately differentiated, and 12.23 for poorly differentiated tumors. The mean SUV<jats:sub>max</jats:sub> was significantly different for well‒differentiated versus poorly differentiated cervical tumors (<jats:italic>P</jats:italic> = .0474).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>Cervical tumor FDG uptake varied by histology and differentiation. SC tumors demonstrated a significantly higher SUV<jats:sub>max</jats:sub> compared with nonsquamous cell tumors, and poorly differentiated tumors also had a higher SUV<jats:sub>max</jats:sub>. Cancer 2009. © 2009 American Cancer Society.</jats:p></jats:sec>