New trends in the evaluation and treatment of cervix cancer: the role of FDG-PET.
BACKGROUND
Positron emission tomography (PET) with F18 Flurodeoxyglucose (FDG) has been evaluated and found to be a useful diagnostic tool in a certain number of malignancies, particularly in providing crucial assessment of metabolic activity of the tumour. We herein review and discuss the place and role of FDG-PET scan in cervix carcinoma patients' management.


METHODS
Data for this review were identified by searches of Medline with and without MeSH database and Cancerlit. Studies were selected only if they were randomised clinical trials or historical reports. References were also identified from reference lists in relevant previously published articles. Recent guidelines and meta-analyses were included. Only published articles were taken into consideration.


RESULTS
Although FDG-PET may be useful in the primary cervical tumours morphologic and metabolic evaluation, it seems to have limited place for disease staging in patients with early-stage disease (less than 4 cm). Hybrid PET/CT is an effective imaging technique in the lymph node staging of locally advanced cervix carcinoma with negative CT findings and may lead to substantial changes in treatment planning for several patients. FDG-PET provides meaningful information for the early evaluation of therapeutic response and long-term follow-up.


CONCLUSIONS
Several reports have demonstrated the efficacy of FDG-PET in both pre-treatment staging and post-treatment evaluation of patients with cervical carcinoma. Further evaluation in prospective clinical trials will be required to assess the clinical benefit of this strategy.
Department of Radiotherapy, Institut Gustave Roussy, 39 rue Camille Desmoulins, Villejuif 94805, France. nicolas.magne@igr.fr
Nicolas
N
Magné
Cyrus
C
Chargari
Lisa
L
Vicenzi
Norman
N
Gillion
Taha
T
Messai
Jacques
J
Magné
Gérald
G
Bonardel
Christine
C
Haie-Meder
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods / Q000639:trends; D005260:Female; D019788:Fluorodeoxyglucose F18; D005544:Forecasting; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods* / Q000639:trends; D011182:Postoperative Care; D011300:Preoperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy*
D019788:Fluorodeoxyglucose F18