title: Fluorine-18-fluorodeoxyglucose PET/CT for the evaluation of suspected recurrent uterine leiomyosarcomas.
abstract: BACKGROUND
  Uterine leiomyosarcomas are rare and aggressive malignancies of the uterine corpus with high recurrence rates and poor prognoses. The current recommendation for detection of recurrent uterine leiomyosarcoma involves periodic physical examination and conventional imaging such as CT or MRI. The role of fluorine-18-fluorodeoxyglucose positron emission tomography with integrated computed tomography (FDG-PET/CT) in the detection of recurrent uterine leiomyosarcomas is not yet established.
  
  
  OBJECTIVE
  To evaluate the use of FDG-PET/CT as a single integrated modality for the evaluation of suspected recurrent uterine leiomyosarcomas.
  
  
  METHODS
  A retrospective study was performed on patients who underwent FDG-PET/CT scans for suspected recurrent uterine leiomyosarcoma. Only patients with follow-up data were included in the study. FDG-PET/CT was evaluated as a single integrated imaging modality. A positive lesion on FDG-PET/CT was defined as a focal abnormality detected on either the PET or CT components, or both.
  
  
  RESULTS
  Sixteen consecutive patients over 5 years underwent FDG-PET/CT for suspected recurrent uterine leiomyosarcoma. Five patients were excluded due to incomplete follow-up data. The remaining 11 patients were aged 36-58 years (mean age 48). FDG-PET/CT had a sensitivity of 100% (95% CI 63-100) and specificity of 100% (95% CI 20-100) for the detection of recurrent uterine leiomyosarcomas. Sites of metastases include lungs, peritoneum, liver, pancreas and breast, of which lungs and peritoneum were the most common. Two (18%) patients had discordant findings: FDG-PET negative metastatic nodules in the breast and lung detected on the CT component. The maximum standardized uptake value (SUVmax) of metastatic lesions ranged from 2.0 to 16.0 (mean 7.6).
  
  
  CONCLUSIONS
  FDG-PET/CT as a single integrated modality may be a useful for the evaluation of suspected recurrent uterine leiomyosarcomas. FDG-PET negative discordant nodules detected on the CT component may represent metastases and should be followed up closely.
authors.affiliation: Department of Nuclear Medicine and PET, Singapore General Hospital, Singapore. kao.yung.hsiang@singhealth.com.sg
authors.forename: Yung Hsiang
authors.initials: YH
authors.lastname: Kao
authors.forename: U
authors.initials: U
authors.lastname: Saad
authors.forename: Andrew E H
authors.initials: AE
authors.lastname: Tan
authors.forename: Butch M
authors.initials: BM
authors.lastname: Magsombol
authors.forename: Ajit Kumar
authors.initials: AK
authors.lastname: Padhy
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18