Imaging uterine cervical cancer with FDG-PET/CT: direct comparison with PET.
OBJECTIVE
To compare 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) and PET/computed tomography (CT) for certainty of image interpretation and for diagnostic accuracy in patients with primary and metastatic uterine cervical cancer.


METHODS
Images of 13 patients with cervical cancer having PET/CT examinations were reviewed retrospectively. PET and PET/CT images of all cases were read blindly and randomly by two readers. Foci of increased FDG uptake on PET or PET/CT were classified using a scoring system regarding lesion localization and characterization. PET and PET/CT findings were assessed with all clinical information available, and diagnostic accuracy was determined on a per-lesion and on a per-patient basis.


RESULTS
For both readers, PET/CT provided significantly higher frequencies of definite lesion localization (>30% higher) and definite lesion characterization (>20% higher) compared to the findings on PET alone. The improvement in lesion localization to the definite level by PET/CT provided the definite lesion characterization in at least 50% of cases. PET/CT tended to exhibit higher diagnostic accuracy than PET alone on a lesion-based analysis (92% vs. 78% in reader 1 and 92% vs. 82% in reader 2, respectively). Metastatic disease spread was, however, almost equally evaluated between PET and PET/CT.


CONCLUSIONS
PET/CT was demonstrated to be useful in the definite localization and characterization of foci of increased FDG uptake, which provided its higher diagnostic accuracy than PET alone. PET/CT appears preferable to PET in the evaluation of cervical cancer, although additional study is needed.
Division of Nuclear Medicine, Department of Radiology, Johns Hopkins Medical Institutions, 601 North Caroline Street, Baltimore, MD 21287-0817, USA.
Mitsuaki
M
Tatsumi
Christian
C
Cohade
Robert E
RE
Bristow
Richard L
RL
Wahl
D003627:Data Interpretation, Statistical; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18