The role of 18F-FDG PET in assessing therapy response in cancer of the cervix and ovaries.
For locally advanced cervical cancer, the current literature supports the use of (18)F-FDG PET for assessing treatment response 3 mo after the completion of concurrent chemoradiation. (18)F-FDG PET can provide reliable long-term prognostic information for these patients and, in the future, may be used to guide additional therapy. Investigational areas include the use of (18)F-FDG PET for monitoring response during radiotherapy and chemotherapy in the metastatic and neoadjuvant settings. For ovarian masses, the performance of (18)F-FDG PET in the detection of borderline tumors is limited, and the presence of physiologic (18)F-FDG uptake in normal ovaries of premenopausal women poses another limitation. Preliminary data suggest that the performance of (18)F-FDG PET and (18)F-FDG PET/CT is superior to that of CT alone in initial staging, but the sensitivity of both in the detection of carcinomatosis is limited. Preliminary data also suggest that (18)F-FDG PET may be promising for early prediction of response to chemotherapy and for prediction of response after the completion of chemotherapy. (18)F-FDG PET and (18)F-FDG PET/CT are most helpful in the evaluation of patients with suspected recurrent ovarian carcinoma, especially when CA-125 levels are rising and CT findings are normal or equivocal. PET and CT are complementary, and PET/CT should be used when available. Preliminary data suggest that the addition of (18)F-FDG PET/CT to the evaluation of these patients changes management in approximately a third and reduces overall treatment costs by accurately identifying patients who will or will not benefit from surgery.
Schwarz
Julie K
JK
Department of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri, USA.
Grigsby
Perry W
PW
Dehdashti
Farrokh
F
Delbeke
Dominique
D
D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000628:therapy*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18