Pre- and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer Julie Leseur, Geoffrey Roman-Jimenez, Anne Devillers,

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Pre- and per-treatment 18F-FDG PET/CT parameters to predict recurrence and survival in cervical cancer Julie Leseur, Geoffrey Roman-Jimenez, Anne Devillers, Juan D. Ospina-Arango, Daniele Williaume, Joel Castelli, Pierre Terve, Vincent Lavoue, Etienne Garin, Florence Lejeune, Oscar Acosta, Renaud De Crevoisier Radiotherapy and Oncology Volume 120, Issue 3, Pages 512-518 (September 2016) DOI: 10.1016/j.radonc.2016.08.008 Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Evolution of values of MTV (A) and TLG (B) quantified before treatment in PET1 (in blue) and during RTCT at 40Gy in PET2 (in red) according to the different SUVmax thresholds (from 30% to 70%). Square and diamond shapes correspond to the mean values of the parameters for all the patients (n=53). Errors bars are standard deviations. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) Radiotherapy and Oncology 2016 120, 512-518DOI: (10.1016/j.radonc.2016.08.008) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 C-index values for SUVmax, MTV and TLG calculated before treatment in PET1 and during RTCT at 40Gy in PET2, depending on different SUVmax threshold (from 30% to 70% of SUVmax) to predict DFS (A) or OS (B). To estimate the predictive capabilities of PET parameters on survivals, Harrell’s C-index values were calculated (c-index) (c-index≈0.5→not predictive, c-index≈1→predictive) (21). The c-index was used to identify the SUVmax thresholds that offered the strongest predictive value for MTV and TLG. Radiotherapy and Oncology 2016 120, 512-518DOI: (10.1016/j.radonc.2016.08.008) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 Disease Free Survival (DFS) (A) and overall survival (OS) (B) curves among patients with cervical cancer stratified by metabolic tumor volume (MTV1(55%)) estimated on PET1 (before treatment). The MTV1 has been calculated with a segmentation of 55% of SUVmax. The population has been divided in 2 groups according to the median values of MTV1 (=9.8cc). The number of patients at risk are given for the patients with recurrence (in green) and without recurrence (in blue). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) Radiotherapy and Oncology 2016 120, 512-518DOI: (10.1016/j.radonc.2016.08.008) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Disease Free Survival (DFS) (A) and overall survival (B) curves among patients with cervical cancer stratified by total lesion glycolysis (TLG2(32%)) estimated on PET2 (at 40Gy). TLG2 has been calculated in a segmentation of 32% of SUVmax. The population has been divided in 2 groups according to the median values of TLG2(32%) (=30.4). The number of patients at risk are given for the patients with recurrence (in green) and without recurrence (in blue). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) Radiotherapy and Oncology 2016 120, 512-518DOI: (10.1016/j.radonc.2016.08.008) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions