Tumor-to-background ratios of the maximum standardized uptake value could not indicate the prognosis of advanced high-grade serous ovarian cancer patients

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Our study aimed to explore the prognostic influence of tumor-to-background ratios (TBRs) of the maximum standardized uptake value (SUVmax) in advanced high-grade serous ovarian cancer (HGSC) patients.

Patients and methods

We retrospectively investigated 51 advanced HGSC patients who underwent PET/CT before primary surgery at our hospital between January 2010 and June 2015. None of these patients received neoadjuvant chemotherapy. SUVmax of ovarian tumor (SUVmax-P) and background (SUVmax-B) were measured using a PET/CT workstation. TBR was calculated by SUVmax-P/SUVmax-B. Backgrounds included the liver, mediastinum, and muscle, and TBRs were noted as TBR-L, TBR-Me, and TBR-Mu, respectively. The χ2-test was used to analyze the relationships between PET/CT parameters and several clinical features. Progression-free survival and overall survival were analyzed using the Kaplan–Meier method and log-rank tests in univariate analyses.


The median (range) follow-up duration was 27 (8–61) months. The median (range) PET/CT parameter values were as follows: SUVmax, 11.41 (3.24–24.14), TBR-L, 2.84 (2.08–11.93), TBL-Me, 2.09 (1.33–9.07), and TBR-Mu, 1.04 (0.56–14.02). The patients were categorized into low and high groups by the median values of these parameters above separately. A larger proportion of patients in the high TBR-Me group were chemoresistant compared with the low-value group (P=0.039). Neither the residual disease nor the ascites levels correlated with SUVmax or TBR values. There were no differences in progression-free survival and overall survival between the patients in the high and low TBR level groups.


TBRs of SUVmax were not prognostic indicators for advanced HGSC patients.

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