Detection of early recurrence with 18F-FDG PET in patients with cervical cancer.
This study investigated the feasibility of PET with (18)F-FDG to evaluate retrospectively early recurrence in patients with cervical cancer.


METHODS
From September 1997 to March 2000, 249 patients with no evidence of cervical cancer after treatment were investigated with (18)F-FDG PET. (18)F-FDG PET scanning, beginning 50 min after injection of 370-555 MBq (18)F-FDG, was performed. (18)F-FDG uptake other than physiologic uptake was evaluated with the standardized uptake value and was analyzed by 2 observers who were unaware of CT or MRI data. CT or MRI and needle biopsies were performed to evaluate the positive lesions on (18)F-FDG PET, and all patients were monitored closely for 6 mo for recurrence.


RESULTS
Of the 249 patients, 80 patients (32.1%) showed positive lesions with (18)F-FDG PET, and 28 patients (11.2%) were clinically or histologically confirmed as having recurrences. Eighty-two percent of recurrence was detected within 6-18 mo after diagnosis, and 89% of recurrence occurred in Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage IIb and stage III patients. The sensitivity and specificity of (18)F-FDG PET for detection of early recurrence were 90.3% and 76.1%, respectively. The sensitivity of (18)F-FDG PET was high in mediastinal, hilar, and scalene lymph nodes, spine, and liver; however, the sensitivity was relatively low in lung, retrovesical lymph nodes, and paraaortic lymph nodes. Three false-negative cases were detected in lung, retrovesical lymph nodes, and paraaortic lymph nodes.


CONCLUSIONS
(18)F-FDG PET was effective in detecting early recurrences in cervical cancer patients with no evidence of disease. (18)F-FDG PET may be a useful follow-up method for cervical cancer, thereby providing the patients with early opportunities for sophisticated treatments.
Ryu
Sang-Young
SY
Department of Obstetrics & Gynecology, Korea Cancer Center Hospital, Seoul, Korea. ryu@kcch.re.kr
Kim
Moon-Hong
MH
Choi
Suck-Chul
SC
Choi
Chang-Woon
CW
Lee
Kyung-Hee
KH
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18