[Genetic analysis of three fetusesaffected with cardiac rhabdomyomas].

OBJECTIVE: To report on echocardiographic finding and genetic testing of three fetuses with cardiac rhabdomyoma. METHODS: Clinical data of the three fetuses was collected. High-throughput sequencing was carried out to analyze the whole exomes of the three fetuses. Suspected variants were confirmed by Sanger sequencing. RESULTS: Multiple hyperechoic masses were found in both ventricles of the three fetuses, suggesting the presence of fetal cardiac rhabdomyoma. Genetic testing revealed that fetus 1 carried a heterozygous c.740G>A (p.W247*) variant of the TSC1 gene, fetus 2 carried a previously known heterozygous c.3352C>T (p.Q1118*) variant of the TSC2 gene. Fetus 3 carried a previously known heterozygous c.1579C>T (p.Q527*) variant of the TSC1 gene. None of their parents carried the same variant. Literature review has identified 109 fetuses with relatively complete data. Cardiac rhabdomyomas in ventricles and ventricular septum was reported in 89, and multiple cardiac rhabdomyoma was reported in 79. Out of the 94 cases who underwent genetic testing, 74 have carried variants of the TSC1 or TSC2 genes. CONCLUSION: Fetal cardiac rhabdomyoma may present as multiple hyperechoic intraventricular masses. Most of them are associated with other manifestation of tuberous sclerosis. Such cases may warrant prenatal genetic testing.

Value of 18F-FDG PET/CT for predicting EGFR mutations and positive ALK expression in patients with non-small cell lung cancer: a retrospective analysis of 849 Chinese patients.

PURPOSE: Epidermal growth factor receptor (EGFR) mutations and the anaplastic lymphoma kinase (ALK) rearrangement are the two most common druggable targets in non-small cell lung cancer (NSCLC). However, genetic testing is sometimes unavailable. Previous studies regarding the predictive role of 18F-FDG PET/CT for EGFR mutations in NSCLC patients are conflicting. We investigated whether or not 18F-FDG PET could be a valuable noninvasive method to predict EGFR mutations and ALK positivity in NSCLC using the largest patient cohort to date. METHODS: We retrospectively reviewed and included 849 NSCLC patients who were tested for EGFR mutations or ALK status and subjected to 18F-FDG PET/CT prior to treatment. The differences in several clinical characteristics and three parameters based on 18F-FDG PET/CT, including the maximal standard uptake value (SUVmax) of the primary tumor (pSUVmax), lymph node (nSUVmax) and distant metastasis (mSUVmax), between the different subgroups were analyzed. Multivariate logistic regression analysis was performed to identify predictors of EGFR mutations and ALK positivity. RESULTS: EGFR mutations were identified in 371 patients (45.9%). EGFR mutations were found more frequently in females, non-smokers, adenocarcinomas and stage I disease. Low pSUVmax, nSUVmax and mSUVmax were significantly associated with EGFR mutations. Multivariate analysis demonstrated that pSUVmax < 7.0, female sex, non-smoker status and adenocarcinoma were predictors of EGFR mutations. The receiver operating characteristic (ROC) curve yielded area under the curve (AUC) values of 0.557 and 0.697 for low pSUVmax alone and the combination of the four factors, respectively. ALK-positive patients tended to have a high nSUVmax. Younger age and distant metastasis were the only two independent predictors of ALK positivity. CONCLUSION: We demonstrated that low pSUVmax is associated with mutant EGFR status and could be integrated with other clinical factors to enhance the discriminability on the EGFR mutation status in some NSCLC patients whose EGFR testing is unavailable.

[Prenatal diagnosis and intervention to fetal hydrothorax: five cases analysis].

OBJECTIVE: To research the important of prenatal diagnosis and effect of intervention to fetal hydrothorax. METHODS: The cases of fetal hydrothorax (n=5) were obtained from the Shengjing Hospital, China Medical University between December 2014 and May 2015. All pregnancies were uncomplicated, excluded congenital organic and chromosomal abnormalities during prenatal diagnosis and with a 37 average gestational weeks. The case 1, 2, 4 were unilateral hydrothorax and the case 3, 5 were bilateral. We performed an antenatal thracocentesis to case 1, 2, 3. In case1, the hydrothorax increased rapidly after 5 days, and the patient underwent a cesarean section and ex utero intrapartum treatment (EXIT); in case 2, the fetal heart rate was decreased to 40-50 bpm suddenly during thracocentesis, and we performed an emergent cesarean section and EXIT for the patient; in case 3, the patient underwent thracocentesis and a meanwhile cesarean section and EXIT procedure. We performed a conservative management to case 4, 5, the hydrothorax resolved spontaneously during the pregnancy and after birth, both patients underwent cesarean section. RESULTS: All fetuses were survived, the neonates of case 1, 2 and 3 underwent assited mechanical ventilation, thoracic close drainage, then discharged after hydrothorax resolved and feeding tolerance; in case 4, there was no respiratory distress and hospital treatment; in case 5, the neonate underwent assited mechanical ventilation and conservative management, the hydrothorax has resolved gradually. CONCLUSIONS: The prenatal diagnosis and antenatal intervention (thracocentesis) may play an important role in fetal hydrothorax treatment. In clinical, we should choose different plan according to the gestation weeks and classification of hydrothorax of the patient.

[Clinical management and perinatal outcome of twin reversed arterial perfusion sequence in different stage].

OBJECTIVE: To discuss the methods and outcomes of twin reversed arterial perfusion sequence in different stage. METHODS: From August 2012 to December 2013, 11 cases were diagnosed with twin reversed arterial perfusion sequence (TRAP) by 3d color Doppler ultrasound in the Maternal ang Fetal Medicine Center, Affiliated Shengjing Hospital, China Medical University, including 3 cases in stage I a, 7 in stage II a and 1 case in stage II b. We performed expected therapy to 3 cases in stage I a and 4 cases in stage II a [1 case (case 9) in stage II a developed to stage II b and was terminated by emergency cesarean section], radio frequency ablation (RFA) selective reduction to 3 cases in stage II a, emergency cesarean section to 1 case in stage II b. All cases except case 1, 4 took cesarean section to terminate pregnancy and would be followed up on the aspect of infant's growth. RESULTS: (1) 3 cases in stage I a were monitored by sequential ultrasound examination, all donors grew normally, in which 2 acardias arised spontaneous cessation of flow and were implemented of cesarean section after the normal period of gestation; 1 case suffered premature rupture of membrane and experienced the natural childbirth at 34 gestation weeks plus 5 days. The survived average labor weight was 2 923 g. (2) In the 7 stage II a cases, 3 cases were implemented of RFA selective reduction, 2 cases survived and the average labor gestation was 35 weeks plus 1 day and average labor weight was 2 050 g; in 3 expected therapy cases, 1 case suffered premature rupture of membrane at 34 gestation weeks plus 5 days and experienced cesarean section; 1 case was observed for 3 weeks and the donor was stillborn; 1 case progressed to stage II b and experienced cesarean section at 34 gestation weeks plus 5 days; and 1 case was lost of follow up. (3) For 2 cases of stage II b cases, one was progressed from stage II a during expected therapy; the other one had been already in stage II b since visiting and experimented an emergency cesarean section, but the neonate died of heart failure two days after labor. (4) 7 survived neonates were followed up, all had a normal condition compared to kids of the same age, except one suffering a congenital heart disease, patent ductus arteriosus and atrial septal defect and whose weight (6 kg at 7 months) was lighter. CONCLUSIONS: We should make the diagnosis of TRAP as early as soon and choose appropriate therapy according to the stage. According to our research, cases in stage I a can undergo an expected therapy under a sequential ultrasound examination; cases in stage II a can undergo a RFA selective reduction to improve the prognosis of the donor, which can make a good perinatal outcome.

Comparison of efficacies of haploidentical transplantation and matched sibling donor transplantation in treating T-cell lymphoblastic lymphoma.

OBJECTIVE: To investigate the differences in efficacy and safety between haploidentical donor hematopoietic stem cell transplantation (HID-HSCT) and matched sibling donor HSCT (MSD-HSCT) in patients with T-cell lymphoblastic lymphoma (T-LBL). METHODS: In this retrospective analysis, we enrolled 38 patients who had undergone allogeneic HSCT at our institution between 2013 and 2021. The study participants included 28 patients who underwent HID-HSCT and 10 patients who underwent MSD-HSCT. We compared the patient characteristics and treatment effectiveness and safety between the two groups and evaluated potential prognostic variables for patients with T-LBL. RESULTS: The median follow-up durations in the HID-HSCT and MSD-HSCT groups were 23.5 (range: 4-111) and 28.5 (range: 13-56) months, respectively. All patients showed full-donor chimerism after hematopoietic stem cell transplantation (HSCT). Except for two patients in the HID-HSCT cohort who developed poor graft function, all patients showed neutrophil and platelet engraftments after HSCT. The cumulative incidences of grades III-IV acute graft-versus-host disease were 37.5% and 28.57% in the HID-HSCT and MSD-HSCT groups, respectively (p = 0.84). The cumulative incidences of limited (34.13% vs. 28.57%, p = 0.82) and extensive (31.22% vs. 37.50%, p = 0.53) chronic graft-versus-host disease did not differ between the two cohorts. In the HID-HSCT and MSD-HSCT cohorts, the estimated 2-year overall survival rates were 70.3% (95% confidence interval [CI]: 54.9%-90.0%) and 56.2% (95% CI: 31.6%-100%), respectively (p = 1.00), and the estimated 2-year progression-free survival (PFS) rates were 48.5% (95% CI: 32.8%-71.6%) and 48.0% (95% CI: 24.6%-93.8%), respectively (p = 0.94). Furthermore, the Cox proportional-hazards model showed that a positive positron emission tomography/computed tomography (PET/CT) status before HSCT in patients who had completed chemotherapy was an independent risk factor for PFS in the multivariate analysis (p = 0.0367). CONCLUSION: This study showed that HID-HSCT had comparable effectiveness and safety to MSD-HSCT in treating T-LBL. HID-HSCT could serve as an alternate treatment option for T-LBL in patients without an eligible identical donor. Achievement of the PET/CT-negative status before HSCT may contribute to better survival.

A new approach to automatic measure fetal head circumference in ultrasound images using convolutional neural networks.

Fetal head circumference (HC) is an important biological index in prenatal ultrasound screening. In the clinic, fetal HC is usually measured manually by sonographers in two dimensional (2D) ultrasound images. The manual method is significantly affected by the inter/intra-observer difference and the process of manual measurement is inconvenient and time-consuming for sonographers. Although several artificial intelligence (AI) approaches had been applied to fetal HC measurement, they had weak generalization ability, especially for the incomplete or blurred skull edge. In this study, a fast and accurate method for fetal HC auto-measurement was proposed. Different from the common region segmentation method, an end-to-end convolutional neural network (CNN) for fetal skull boundary segmentation in 2D ultrasound images is proposed, which is an efficient method to directly segment the boundary of fetal skull by using the proposed double-branch structure. The segmentation results can be directly used to calculate fetal HC without complex post-processing. The proposed approach achieved excellent results: Mean Dice Sore (MDS)±std: 97.98 ± 1.30, Mean Hausdorff Distance (MHD)±std: 1.20 ± 0.68 mm, Mean Absolute Difference (MAD)±std: 1.75 ± 1.60 mm, Mean Difference (MD)±std: 0.08 ± 2.37 mm. Additionally, we drew a Bland-Altman plot to demonstrate that HC measured by the proposed approach has high agreement with the real value. Comprehensive results show that the proposed approach is comparable to the state-of-the-art methods for fetal HC measurement. Meanwhile, our approach belongs to a lightweight network with less parameters, which is convenient for deployment. We hope it could provide help for precision medicine in prenatal ultrasound screening.

RDHCformer: Fusing ResDCN and Transformers for Fetal Head Circumference Automatic Measurement in 2D Ultrasound Images.

Fetal head circumference (HC) is an important biological parameter to monitor the healthy development of the fetus. Since there are some HC measurement errors that affected by the skill and experience of the sonographers, a rapid, accurate and automatic measurement for fetal HC in prenatal ultrasound is of great significance. We proposed a new one-stage network for rotating elliptic object detection based on anchor-free method, which is also an end-to-end network for fetal HC auto-measurement that no need for any post-processing. The network structure used simple transformer structure combined with convolutional neural network (CNN) for a lightweight design, meanwhile, made full use of powerful global feature extraction ability of transformer and local feature extraction ability of CNN to extract continuous and complete skull edge information. The two complement each other for promoting detection precision of fetal HC without significantly increasing the amount of computation. In order to reduce the large variation of intersection over union (IOU) in rotating elliptic object detection caused by slight angle deviation, we used soft stage-wise regression (SSR) strategy for angle regression and added KLD that is approximate to IOU loss into total loss function. The proposed method achieved good results on the HC18 dataset to prove its effectiveness. This study is expected to help less experienced sonographers, provide help for precision medicine, and relieve the shortage of sonographers for prenatal ultrasound in worldwide.

Characteristics of microbial community composition and its relationship with carbon, nitrogen and sulfur in sediments.

Microorganisms play an important role in the biogeochemical cycles of lacustrine sediments. However, little is known about their vertical responses to sedimentary depths and their contributions to important element cycles such as carbon, nitrogen and sulfur. Here, we investigated the community features of sedimental prokaryotes along with vertical profiles (i.e., sedimental depths of 0-230 cm) in the Dongting watershed. In the entire profile, the bacterial diversity wavelike decreased with increasing sediment depths, whereas archaeal diversity increased monotonically in the deep layer (100-230 cm). Bacteria were more sensitive to sedimental depths than archaea (B: P < 0.001, R = 0.534; A: P < 0.001, R = 0.327). The relative abundance of the primary phylum of bacteria (e.g. Proteobacteria) and archaea (e.g. Thaumarchaeota) changed significantly with sediment layers (P < 0.05). The vertical distribution of prokaryotes in sediments was related to the changes in sediment properties (P < 0.05, e.g., the content of nutrients, pH, texture, etc.). The co-occurrence network analysis further indicated that the superficial (0-40 cm) and deep (100-230 cm) networks contained more tightly connected node groups (more modules number), while the tighter connections (shorter APL) and more complex networks (higher avgK) were seen in sub-deep (40-100 cm) sediments. Based on the FAPROTAX database, we found that the predicted prokaryotic microbial functional groups involved in the N cycle had the highest abundance (87.47%), followed by the C cycle (9.48%) and the S cycle (2.39%). In addition, these groups were enriched in the superficial and deep layers. Taken together, these results reveal a new perspective on the vertical spatial variation in microorganisms at the fine-scale of the lake sediments. Distinct microbiome response patterns may have important implications for carbon, nitrogen and sulfur cycling along with the sediment profile in Dongting lake ecosystems.

Metallohydrogel with Tunable Fluorescence, High Stretchability, Shape-Memory, and Self-Healing Properties.

Aiming at the problem that the reported smart optical metallohydrogels were limited with poor mechanical properties, we reported here a novel smart optical metallohydrogel (Al-hydrogel) with excellent elongation, shape-memory ability, self-healing property, and controllable fluorescence intensity. The Al-hydrogel was obtained by the HHPMA-Al3+ and carboxylate-Al3+ coordination after one-pot micellar copolymerization of acrylic acid (AAc), acrylamide (AAm), and hydrophobic arylhydrazone-based ligand (HHPMA). This hydrogel was able to extend up to 5000% of its original length without fracture. Its emission intensity was tunable by OH-/H+ or Zn2+/AAc and increased by 500% with 0.1 M OH- or Zn2+. Its tunable fluorescence enabled us to repeatedly pattern it. A reversible system consisting of Fe3+/H+, was implemented to control the shape of the Al-hydrogel, endowing the Al-hydrogel with shape-memory ability. This highly stretchable and multifunctional Al-hydrogel has potential applications in information transmission, wearable devices, and flexible sensors.

Identifying miRNA-mRNA Pairs and Novel miRNAs from Hepatocelluar Carcinoma miRNomes and TCGA Database.

Increasing evidence shows microRNAs (miRNAs) are engaged in hepatocelluar carcinoma (HCC). To identify novel feasible miRNA/mRNA pairs involved in hepatocarcinogenesis, an in-depth analysis of miRNomes in human non-tumor liver and HCC samples was carried out in this study. Firstly, differentially expressed miRNAs were obtained from deep sequencing of 15 liver samples, and verified in an independent data from The Cancer Genome Atlas (TCGA) database. Then, differentially expressed mRNA targets were selected from TCGA, and the differential miRNA/mRNA pairs with negative correlations were screened out. Finally, functional enrichment analysis was used to predict the functions of miRNA/mRNA pairs in HCC. In our study, 81 miRNA/mRNA pairs and 7 novel miRNAs were found. We constructed a hub interaction model with 9 miRNA/mRNA pairs to further investigate molecular mechanism of HCC. Survival analysis identified nine genes (hsa-miR-137, hsa-miR-490, BIRC5, TOP2A, CDC25C, IGF2BP1, IQGAP3, NCAPG and VIPR1) with significant influence on prognosis of HCC patients. In conclusion, the miRNA/mRNA pairs identified in our study may have some potential values to be further studied in progression, diagnosis and prognosis of HCC.

Self-Healing and Multistimuli-Responsive Hydrogels Formed via a Cooperation Strategy and Their Application in Detecting Biogenic Amines.

We reported here a new platform of supramolecular hydrogels cross-linked by the cooperation of metal-ligand coordination and hydrophobic interaction. A salicylaldehyde benzoyl hydrazone-terminal poly(ethylene glycol) (2SBH-PEG) was synthesized and formed small micelles in an aqueous environment. Addition of Ni2+ connected the low-molecular-weight 2SBH-PEG into a metallopolymer via metal-ligand coordination and led to micelle aggregation, resulting in gelation due to the enhancement of hydrophobic interaction. The forming hydrogel, Ni-PEGel, exhibited rapid self-healing ability and reversible pH-responsive property. Because of the containing metal coordination bond, it was also sensitive to the strong competing ligands, such as ethylenediaminetetraacetic acid (EDTA) and pyridine. In addition, Ni-PEGel showed colorimetric changes when exposed to biogenic amine (BA) vapor. The color development of Ni-PEGel toward BAs makes it a good candidate in monitoring food spoilage.

Whole Body Positron Emission Tomography/Computed Tomography (PET/CT) in the Evaluation of Ophthalmic Tumors.

The clinical value of whole body positron emission tomography/computed tomography (PET/CT) as an imaging tool in diagnosis of ophthalmic tumors was investigated. The retrospective observational case series were performed on the patients with suspected ophthalmic tumors who underwent whole body PET/CT. The golden standard of diagnosis was the final pathological diagnosis or the results of long-term follow-up for patients without surgery/biopsy. PET/CT findings were compared with the golden standard. The sensitivity, specificity, accuracy and positive likelihood ratio of PET/CT in the detection of ophthalmic tumors were calculated. The clinical application of PET/CT in different types of ophthalmic tumors was evaluated. The results showed that 30 patients (18 males and 12 females) with a mean age of 43.0 years (range 4-63 years) were collected. The mean sizes of orbital tumors and intraocular tumors were 26.8 mm×17.8 mm and 11.2 mm×6.1 mm, respectively. The overall sensitivity, specificity, accuracy and positive likelihood ratio of whole body PET/CT in ophthalmic tumors were 76.5%, 71.4%, 75.0% and 2.67, and were 62.5%, 100% and 70.0% in intraocular tumors, and those were 100%, 60.0% and 84.6% in orbital tumors, respectively. PET/CT findings were applied to help make appropriate treatment options in 27 out of 30 patients (90.0%), and 12 (40.0%) patients changed the treatment strategy. False negative results in 4 cases and false positive results in 2 cases were observed in this series. It was suggested that PET/CT was an effective imaging modality in detecting, diagnosing and developing therapeutic schedule for patients with ophthalmic tumors. It was more sensitive and accurate for detecting orbital tumors than for detecting intraocular tumors.

Prognostic Value of Volume-Based Positron Emission Tomography/Computed Tomography in Nasopharyngeal Carcinoma Patients after Comprehensive Therapy.

Objective: We assessed the prognostic value of standardized uptake value (SUV) and volume-based methods including whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) of patients with nasopharyngeal carcinoma (NPC) after therapy. Methods: A total of 221 posttherapy NPC cases were enrolled, all of whom had undergone PET/CT scanning and follow-up in this retrospective study. The diagnostic results of PET/CT were analyzed and compared with histopathological diagnosis or clinical follow-up. Receiver operator characteristic curves, the Kaplan-Meier method, and the log-rank test were used to assess the optimal cutoff values for WBMTV and WBTLG to identify independent predictors of survival. Results: The detection rates of the threshold SUV were 2.5, 20%, and 40%, and SUV background methods were 65.6% (378/576), 80.2% (462/576), 71.5% (412/576), and 90.4% (521/576), respectively (P < 0.005). Patients with a WBMTV < 8.10 and/or a WBTLG < 35.58 had significantly better 5-year overall survival than those above the cutoffs (90.7% versus 51.2%, P < 0.001; 91.7% versus 50.4%, P < 0.001), respectively. Multivariate Cox regression modeling showed both WBTLG (RR, 1.002; P = 0.004) and age (RR, 1.046; P = 0.006) could be used to predict overall survival. WBTLG (RR, 1.003; P < 0.001) may have predictive relevance in estimating disease-free survival. Conclusions: SUV volume-based threshold background methodology had a significantly higher detection rate for metastatic lesions. WBTLG could be used as an independent prognostic indicator for posttherapy NPC.

A Selective and Purification-Free Strategy for Labeling Adherent Cells with Inorganic Nanoparticles.

Cellular labeling with inorganic nanoparticles such as magnetic iron oxide nanoparticles, quantum dots, and fluorescent silica nanoparticles is an important method for the noninvasive visualization of cells using various imaging modalities. Currently, this is mainly achieved through the incubation of cultured cells with the nanoparticles that eventually reach the intracellular compartment through specific or nonspecific internalization. This classic method is advantageous in terms of simplicity and convenience, but it suffers from issues such as difficulties in fully removing free nanoparticles (suspended in solution) and the lack of selectivity on cell types. This article reports an innovative strategy for the specific labeling of adherent cells without the concern of freely suspended nanoparticles. This method relies on a nanocomposite film that is prepared by homogeneously dispersing nanoparticles within a biodegradable polymeric film. When adherent cells are seeded on the film, they adhere, spread, and filtrate into the film through the micropores formed during the film fabrication. The pre-embedded nanoparticles are thus internalized by the cells during this infiltration process. As an example, fluorescent silica nanoparticles were homogeneously distributed within a polycaprolactone film by utilizing cryomilling and heat pressing. Upon incubation within physiological buffer, no silica nanoparticles were released from the nanocomposite film even after 20 d of incubation. However, when adherent cells (e.g., human mesenchymal stem cells) were grown on the film, they became fluorescent after 3 d, which suggests internalization of silica nanoparticles by cells. In comparison, the suspension cells (e.g., monocytes) in the medium remained nonfluorescent no matter whether there was the presence of adherent cells or not. This strategy eventually allowed the selective and concomitant labeling of mesenchymal stem cells during their harvest from bone marrow aspiration.

Prognostic predictive value of total lesion glycolysis from 18F-FDG PET/CT in post-surgical patients with epithelial ovarian cancer.

PURPOSE: The aim of this study was to determine an optimal threshold method for the segmentation of malignant lesions from (18)F-FDG PET/CT images and to evaluate the prognostic value of the total lesion glycolysis in post-surgical patients with epithelial ovarian cancer. METHODS: We retrospectively reviewed 47 patients with pathologically proven epithelial ovarian cancer who underwent (18)F-FDG PET/CT imaging after surgery. The follow-up time was 26.6 ± 19.8 months (ranged from 4 to 89 months). For each patient, every lesion was segmented by 2 thresholds with 3D-area growing algorithm, standard uptake value (SUV) 2.5, and background method. The detection rates were compared. The optimal threshold method was then used to calculate whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG). The prognostic significance of SUV(max), WBMTV, WBTLG, and other pathological variables for overall survival were assessed by Cox proportional hazards regression analysis and Kaplan-Meier survival analysis. RESULTS: A total of 142 metastatic lesions of 47 patients were confirmed by long-term clinical follow-up or pathological findings. The detection rates of the threshold SUV 2.5 and background methods were 37.32% (53/142) and 96.48% (137/142), respectively, which showed significant difference between the 2 methods (P < 0.005). In multivariate analysis, WBTLG, obtained from the background method, was an independent predictive factor associated with the prognosis (HR 1.043, 95% CI 1.01-1.078, P = 0.011), and none of the other factors had statistical association. Survival analysis also showed that the survival time was clearly shortened with WBTLG increasing (P < 0.001). CONCLUSIONS: In this group of post-surgery patients with epithelial ovarian cancer, the background method could segment much more malignant lesions than SUV = 2.5 method, and WBTLG, obtained from this method, could be used as an independent prognostic factor.