18F-fluorodeoxyglucose positron emission tomography in uterine carcinosarcoma.
OBJECTIVE
Uterine carcinosarcomas clinically confined to the uterus usually harbor occult metastases. We conducted a pilot study to evaluate the value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in uterine carcinosarcoma.


METHODS
Patients with histologically confirmed uterine carcinosarcoma were enrolled. Abdominal and pelvic magnetic resonance imaging (MRI)/whole-body computed tomography (CT) scan, and whole-body (18)F-FDG PET or PET/CT were undertaken for primary staging, evaluating response, and restaging/post-therapy surveillance. The clinical impact of (18)F-FDG PET was determined on a scan basis.


RESULTS
A total of 19 patients were recruited and 31 (18)F-FDG PET scans (including 8 scans performed on a PET/CT scanner) were performed. Positive impacts of scans were found in 36.8% (7/19) for primary staging, 66.7% (2/3) for monitoring response, and 11.1% (1/9) for restaging/post-therapy surveillance. PET excluded falsely inoperable disease defined by MRI in two patients. Aggressive treatment applying to three patients with PET-defined resectable stage IVB disease seemed futile. Two patients died of disease shortly after salvage therapy restaged by PET. With PET monitoring, one stage IVB patient treated by targeted therapy only was alive with good performance. Using PET did not lead to improvement of overall survival of this series compared with the historical control (n = 35) (P = 0.779).


CONCLUSIONS
The preliminary results suggest that (18)F-FDG PET is beneficial in excluding falsely inoperable disease for curative therapy and in making a decision on palliation for better quality of life instead of aggressive treatment under the guidance of PET. PET seems to have limited value in post-therapy surveillance or restaging after failure.
Ho
Kung-Chu
KC
Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 5 Fu-Shin Street, Taoyuan, Taiwan.
Lai
Chyong-Huey
CH
Wu
Tzu-I
TI
Ng
Koon-Kwan
KK
Yen
Tzu-Chen
TC
Lin
Gigin
G
Chang
Ting-Chang
TC
Wang
Chun-Chieh
CC
Hsueh
Swei
S
Huang
Huei-Jean
HJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002296:Carcinosarcoma / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18