Prognostic relevance of F-18 fluorodeoxyglucose positron emission tomography and computed tomography in molar pregnancy before evacuation.
OBJECTIVE
To assess prognostic significance of tumor metabolic activity of molar tissue by preevacuation F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) in patients clinically diagnosed with molar pregnancy.


METHODS
A total of 11 consecutive patients with clinical diagnosis of molar pregnancy before evacuation were enrolled. After evacuation of molar tissue, histopathologic findings and clinical follow-up were used as reference standards for the study.


RESULTS
Six patients, 5 with complete and 1 with partial hydatidiform mole, had good outcome and normalization of beta-human chorionic gonadotropin (beta-hCG) levels within 5-7 weeks of evacuation. In the other 5 patients, serial measurements showed persistently and/or progressively elevated beta-hCG serum levels. These patients were treated with first-line single methotrexate or second-line etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine (EMA/CO) chemotherapy regimen. Standardized uptake value of molar tissue within the uterus in patients with persistently/progressively elevated beta-hCG levels was significantly higher than that in patients whose serum beta-hCG levels normalized after evacuation of molar tissue.


CONCLUSIONS
Preliminary results suggest that F-18 FDG uptake within the uterus assessed by preevacuation PET/CT is predictive for probability of high-risk features of gestational trophoblastic disease or choriocarcinoma in patients with molar pregnancy.
Ak
Ilknur
I
Department of Nuclear Medicine, Eskişehir Osmangazi University Medical Faculty, Eskişehir, Turkey. ilknur_ak@yahoo.com
Ozalp
Sinan
S
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D006828:Hydatidiform Mole / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011247:Pregnancy; D011379:Prognosis; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D014599:Uterus / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
D000970:Antineoplastic Agents; D018997:Chorionic Gonadotropin, beta Subunit, Human; D019788:Fluorodeoxyglucose F18