Clinical impact of FDG-PET imaging in post-therapy surveillance of uterine cervical cancer: from diagnosis to prognosis.
OBJECTIVE
To evaluate the ability of whole-body 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) scan to detect recurrent cervical cancer in women during follow-up after definitive treatment.


METHODS
We retrospectively reviewed the whole-body FDG-PET scan of the women who had reached complete response after primary treatment for detection of recurrent cervical cancer between September 1, 2001 and October 31, 2004.


RESULTS
One hundred twenty-one consecutive patients were registered for the current study and seventy-six women were diagnosed as recurrence, twenty of which were asymptomatic. The FDG-PET scan detected 73 (96.1%) patients among 76 patients with recurrent disease and discriminated 38 (84.4%) patients among 45 patients without recurrence. The sensitivity, specificity and accuracy of the FDG-PET scan in assessment of recurrence among patients with cervical cancer were 96.1%, 84.4% and 91.7% respectively. Sixteen patients with no evidence of distant metastasis on FDG-PET scan received pelvic exenteration; complete response was achieved in 6 (37.5%) patients, and all are alive with no evidence of disease. The FDG-PET scan detected FDG-avid lesions in 17 (85.0%) of the 20 asymptomatic patients with recurrent disease, and 8 (40.0%) patients received therapy with curative intent; complete response was achieved in five (25.0%) patients and all are alive with no evidence of disease. Three-year overall survival of this study was 85.6%.


CONCLUSIONS
The whole-body FDG-PET scan is a sensitive post-therapy surveillance modality for detection of recurrent cervical cancer even in asymptomatic patients and aids in deciding treatment plans and, eventually, may have favorable impact on prognosis and survival.
Research Institute and Hospital, National Cancer Center, 809 Madu-dong, Ilsan-gu, Goyang, Gyeonggi 411-769, Republic of Korea.
Hyun Hoon
HH
Chung
Seok-Ki
SK
Kim
Tae Hyun
TH
Kim
Sun
S
Lee
Keon Wook
KW
Kang
Joo-Young
JY
Kim
Sang-Yoon
SY
Park
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care; D010385:Pelvic Exenteration; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016879:Salvage Therapy; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18