Performance of FDG-PET/CT in the diagnosis of recurrent endometrial cancer.
OBJECTIVE
To evaluate the accuracy of integrated positron emission tomography and computed tomography (PET/CT) using 18-F-fluorodeoxyglucose (FDG), compared with PET alone, in the diagnosis of suspected endometrial cancer recurrence.


METHODS
Thirty women who had undergone primary surgery for histopathologically proven endometrial cancer with suspected recurrence because of clinical, cytological, biochemical, and/or radiological findings were enrolled in this study. PET and integrated PET/CT images were evaluated by two different experienced radiologists by consensus for each modality. A final diagnosis of recurrence was confirmed by histopathology, other imaging and clinical follow-up for longer than 1 year. The statistical significance of differences between PET and PET/CT was determined by the McNemar test.


RESULTS
Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/CT were 93% (14/15), 93% (14/15), and 93% (28/30), respectively, whereas for PET, the corresponding data were 80% (12/15), 80% (12/15), and 80% (24/30), respectively (P=0.479, 0.479, and 0.134, respectively). CT from PET/CT resolved the false-positive PET results because of hyper-metabolic activity of benign inflammatory lesions and physiological variants and moreover detected lung metastasis and para-aortic lymph node metastasis that PET missed. However, tiny para-aortic lymph node metastasis could not be detected even with PET/CT.


CONCLUSIONS
Integrated FDG-PET/CT is a useful complementary modality for providing good anatomic and functional localization of sites of recurrence during follow-up of patients with endometrial cancer.
Kitajima
Kazuhiro
K
PET Center, Dokkyo Medical University Hospital, Mibu, Shimotuka, Tochigi, Japan. kazu10041976@yahoo.co.jp
Murakami
Koji
K
Yamasaki
Erena
E
Hagiwara
Shingo
S
Fukasawa
Ichio
I
Inaba
Noriyuki
N
Kaji
Yasushi
Y
Sugimura
Kazuro
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18