Predictive value of 18F-FDG-PET/CT for pathologic complete response (pCR) of lesions after neoadjuvant chemotherapy in advanced ovarian cancer

Q: What is the study’s main goal?

To assess whether 18F-FDG-PET/CT can predict lesion-specific pathological complete response (pCR) after neoadjuvant chemotherapy in advanced epithelial ovarian cancer before interval debulking surgery.

Q: How were PET/CT measurements used in the analysis?

SUVmax was recorded for each metabolically active site before and after neoadjuvant chemotherapy, and the relative change (ΔSUVmax) was analyzed against pCR status and response metrics.

Q: Which PET/CT changes were associated with pCR and treatment response?

Lesion ΔSUVmax after neoadjuvant therapy was significantly associated with pCR, and omental ΔSUVmax correlated positively with KELIM score; specific reduction thresholds were reported for different lesion sites.

Q: What practical impact does the conclusion suggest?

18F-FDG-PET/CT may guide the extent of interval debulking surgery by providing non-invasive prediction of lesion-specific pCR after neoadjuvant chemotherapy.

Sep 30, 2026

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Objective Evaluate whether 18F-FDG-PET/CT predicts pathological complete response (pCR) in lesions of patients with advanced epithelial ovarian cancer after neoadjuvant chemotherapy, focusing on lesion-specific prediction prior to interval debulking surgery. Methods Analyze SUVmax and relative ΔSUVmax changes in metabolically active sites before and after neoadjuvant therapy in 24 patients, relating findings to pCR and to omental response using chemotherapy response score (CRS) and CA125 elimination rate constant K (KELIM). Results Post-NACT lesion ΔSUVmax predicts pCR, with site-specific thresholds. Omental ΔSUVmax correlates with KELIM and distinguishes CRS groups. Conclusion 18F-FDG-PET/CT supports non-invasive guidance for surgical extent by predicting lesion-specific pCR after neoadjuvant chemotherapy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Objective

Methods

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Introduction

Ye etal. World Journal of Surgical Oncology (2026) 24:25 [https://doi.org/10.1186/s12957-025-04138-w](https://doi.org/10.1186/s12957-025-04138-w) World Journal of Surgical Oncology RESEARCH Open Access Predictive value of 18F-FDG-PET/CT for pathologic complete response (pCR) of lesions after neoadjuvant chemotherapy in advanced ovarian cancer Shiyu Ye 1†, Yun Wang2†, Runhua Li3†, Zhuyan Shao4* and Tao Zhu 1,4* Abstract Objective This study aimed to evaluate the ability of 18F-FDG-PET/CT to predict pathological complete response (pCR) in lesions of patients with advanced epithelial ovarian cancer (EOC) following neoadjuvant chemotherapy (NACT) . We assessed whether 18F-FDG-PET/CT could predict lesion-specific pCR prior to interval debulking surgery (IDS), thus guiding precise lesion resection. Methods Twenty-four patients with advanced EOC underwent IDS after NACT. 18F-FDG-PET/CT imaging was performed before and after NACT, with the maximum standardized uptake value (SUVmax) recorded for each metabolically active site. The relationship between the relative change in SUVmax (ΔSUVmax) of grossly visible or suspicious lesions resected during IDS and their pCR status was analyzed. Additionally, the association between omental ΔSUVmax and the chemotherapy response score (CRS) and CA125 elimination rate constant K (KELIM) score was examined. Results Tumor lesion ΔSUVmax Post-NACT was significantly associated with pCR (P < 0. 001, odds ratio [OR] 0. 001, 95% confidence interval [CI]: 0 .000–0. 012) . A reduction in SUVmax >60. 2% predicted pCR in lesions (sensitivity 75. 6%, specificity 79 . 2%), with an area under the curve (AUC) of 0.817 (95% CI: 0 .756–0. 877, P < 0. 05) . Site-Stratified analysis showed that reductions > 59. 6% in peritoneal implants (sensitivity 71 .4%, specificity 95 . 7%, AUC 0 . 905, 95% CI: 0 .821–0. 989, P < 0. 05), > 63. 95% in metastatic lymph nodes (sensitivity 72 . 7%, specificity 94 .4%, AUC 0 . 904, 95% CI: 0.815–0. 994, P < 0. 05) predicted pCR at respective sites, and reductions > 73. 9% in primary lesions (sensitivity 100%, specificity 78 . 9%, AUC 0 . 816, 95% CI: 0 .642–0. 990, P = 0 . 151) predicted a trend toward significance in pCR results. Omental ΔSUVmax differed significantly between CRS1/2 and CRS3 groups (t = 3 .404,P = 0 . 003); a reduction > 49. 95% predicted CRS3 (sensitivity 83 . 3%, specificity 78 . 6%, AUC 0 . 893, 95% CI: 0 .736–1. 000, P < 0. 05) . Omental ΔSUVmax †Shiyu Ye, Yun Wang and Runhua Li contributed equally to this work. *Correspondence: Zhuyan Shao [shaozy@zjcc.org.cn](shaozy@zjcc.org.cn)[ ](shaozy@zjcc.org.cn)Tao Zhu [zhutao@zjcc.org.cn](zhutao@zjcc.org.cn) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Ye et al. World Journal of Surgical Oncology (2026) 24:25 Page 2 of 9 was positively correlated with the KELIM score (r = 0 . 712, P < 0. 001), and primary

FAQs

What is the study’s main goal?

To assess whether 18F-FDG-PET/CT can predict lesion-specific pathological complete response (pCR) after neoadjuvant chemotherapy in advanced epithelial ovarian cancer before interval debulking surgery.

How were PET/CT measurements used in the analysis?

SUVmax was recorded for each metabolically active site before and after neoadjuvant chemotherapy, and the relative change (ΔSUVmax) was analyzed against pCR status and response metrics.

Which PET/CT changes were associated with pCR and treatment response?

Lesion ΔSUVmax after neoadjuvant therapy was significantly associated with pCR, and omental ΔSUVmax correlated positively with KELIM score; specific reduction thresholds were reported for different lesion sites.

What practical impact does the conclusion suggest?

18F-FDG-PET/CT may guide the extent of interval debulking surgery by providing non-invasive prediction of lesion-specific pCR after neoadjuvant chemotherapy.

Sep 30, 2026

Uploaded by kopisore