The role of hybrid PET/CT in the evaluation of patients with cervical cancer.
OBJECTIVE
To assess the role of hybrid PET/CT in the evaluation of patients with cervical cancer.


METHODS
75 patients divided into 3 groups. Group 1 consisted of 16 patients prior to radical surgery. Group 2 consisted of 31 patients prior to pelvic radiotherapy. Group 3 had 28 patients who underwent the examination secondary to suspected recurrent disease. Whole body PET and CT were performed respectively on the same device 1 h after injection of 10 mCi FDG. PET/CT results were correlated to histological, radiological and clinical follow-up data. Only women with >6 months follow-up were included.


RESULTS
In 33 patients, pathohistological examinations for extra cervical lesions were obtained. Correlation with PET/CT examination revealed levels of sensitivity (60%), specificity (94%), positive (90%) and negative predictive values (74%). The examination indicated 21 patients with extrapelvic and/or metastatic disease. The follow-up data of this group revealed that 20 patients either died or were alive with active disease, and only one patient was in clinical remission. PET/CT yielded an improved diagnosis for both PET and CT in 43% of the cases by providing better localization and definition of abnormal FDG uptake.


CONCLUSIONS
Hybrid PET/CT was found to be of value for detection of cervical cancer metastases, decision-making and planning of irradiation therapy. Using this modality may reduce unnecessary surgical interventions, help modify radiation fields and change therapeutic approaches. Detection of advanced diseases on PET/CT correlates with poor prognosis. However, this examination is less accurate in detecting microscopic diseases and lesions smaller than 1.5 cm.
Amit
Amnon
A
Department of Obstetrics and Gynecology, Rambam Medical Center, POB 9602, Haifa 31096, Israel. a_amit@rambam.health.gov.il
Beck
Dan
D
Lowenstein
Lior
L
Lavie
Offer
O
Bar Shalom
Rachel
R
Kedar
Zohar
Z
Israel
Ora
O
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D051598:Whole Body Imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18