title: The diagnostic value of PET/CT scanning in patients with cervical cancer: a prospective study.
abstract: OBJECTIVE
  To investigate the clinical value of PET/CT as a supplement to FIGO staging in patients with cervical cancer stage >or=1B.
  
  
  METHODS
  This prospective study included 120 consecutive patients. After staging, a whole-body PET/CT scan was performed and these examinations were divided into two groups: (1) patients suitable for radical hysterectomy including lymph node dissection and (2) patients referred to combined chemo/radiation therapy. The results were compared to histopathological findings and/ or follow-up.
  
  
  RESULTS
  Twenty-seven patients underwent radical surgery; four of these had PET/CT scans revealing pathological foci in the pelvis. Three (11%) were true positive; one was false positive. Twenty-two patients had true negative PET/CT scans concerning pelvic lymph nodes. One patient had a false negative node. For these patients, we found the positive predictive value (PPV) to be 75%, negative predictive value (NPV) 96%, sensitivity 75%, specificity 96%. Regarding para-aortal nodal disease in the total population of 119 patients, 15 patients had true positive scans. The number of true negatives was 103, resulting in PPV 94%, NPV 100%, sensitivity 100% and specificity 99%. PET/CT scans showed distant metastases in 19 patients, 10 were true positive and nine were false positive. The remaining 100 patients were considered true negative for distant metastases and for these patients, we found PPV 63%, NPV 100%, sensitivity 100% and specificity 94%.
  
  
  CONCLUSIONS
  Whole-body FDG PET/CT scanning for newly diagnosed cervical cancer FIGO stage >or=1B has a high sensitivity and specificity, and can be a valuable supplement to the FIGO staging procedure.
authors.affiliation: PET and Cyclotron Unit 3982, Department of Clinical Physiology and Nuclear Medicine, Centre of Diagnostic Investigations, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. annika.loft@rh.hosp.dk <annika.loft@rh.hosp.dk>
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
authors.forename: Anne Kiil
authors.initials: AK
authors.lastname: Berthelsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Roed
authors.forename: Christian
authors.initials: C
authors.lastname: Ottosen
authors.forename: Lene
authors.initials: L
authors.lastname: Lundvall
authors.forename: Jens
authors.initials: J
authors.lastname: Knudsen
authors.forename: Lotte
authors.initials: L
authors.lastname: Nedergaard
authors.forename: Liselotte
authors.initials: L
authors.lastname: Højgaard
authors.forename: Svend Aage
authors.initials: SA
authors.lastname: Engelholm
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18