For women with endometrial cancer, knowing whether the cancer has spread to nearby lymph vessels is crucial for treatment decisions. Currently, that requires surgery. But a new analysis of 257 patients suggests a noninvasive PET scan measure might help.
The measure, called SUVmax, looks at how much sugar the cancer cells take up on a PET scan. The analysis found that SUVmax can detect lymphovascular space invasion (LVSI) with 83% specificity, meaning it correctly rules out the spread in most cases. Its sensitivity was 62%, so it misses some cases. Overall accuracy was moderate, with an AUROC of 0.77.
However, the results may be less reliable than they appear. One study in the analysis had a big influence on the findings, and more research with larger groups is needed. This is not yet ready for routine use, but it offers a glimpse of a future where some women might avoid surgery to check for spread.
Common questions
What is SUVmax and how is it measured?
SUVmax stands for maximum standardized uptake value. It is a number calculated from a PET scan that shows how active the cells are. Cancer cells often take up more sugar, so a higher SUVmax can indicate more aggressive cancer. It is measured noninvasively during a PET/CT or PET/MR scan.
How accurate is SUVmax for detecting lymphovascular space invasion?
In this analysis of 257 patients, SUVmax had moderate accuracy. It correctly identified 83% of cases without LVSI (specificity) and detected 62% of cases with LVSI (sensitivity). The overall accuracy, measured by AUROC, was 0.77. However, results may be influenced by one study, so more research is needed.
Can SUVmax replace surgery for checking cancer spread?
Not yet. This analysis shows promise, but the accuracy is only moderate, and the results may be unstable. Currently, surgery is still the standard way to check for lymphovascular space invasion. More studies with larger groups are needed before SUVmax could be used alone to guide treatment decisions.
