title: PET/CT imaging in gynecologic malignancies: a critical overview of its clinical impact and our retrospective single center analysis.
abstract: Gynecologic cancers represent a major global healthcare problem since they are associated with a significant mortality and morbidity. Over the last decade, considerable efforts have been spent in the development and optimization of novel diagnostic modalities to achieve an early diagnosis, aid in choosing appropriate treatment, improving long term surveillance, with the ultimate goal of increasing survival of gynecologic cancer patients. A growing body of evidence defines PET/CT as one of the most powerful tools for tumor, nodal and metastasis (TNM) cancer staging both in pre-treatment and in post treatment follow-up settings. At any phase of cancer evaluation, detection of metastasis represents one of the most critical impediments to the cure of tumor; traditional diagnostic imaging modalities, such as computed tomography (CT), are frequently found to inadequately stage the tumor, based on subsequent outcomes. As a consequence, patients may undergo pointless surgery for disease that could be treated with local medical therapies. In the setting of restaging, the ability to describe primary lesion, lymph nodes, possible metastases to peritoneum, bone, liver, lungs and brain renders PET/CT a potential alternative for a series of tests, including bone scanning, MRI or ultrasound, diagnostic CT, lymph node surgical sampling, that need to be used in combination in order to obtain a level of clinical confidence. In this review, we describe, the theoretical advantage and prognostic implications of PET/CT in the management of gynecologic cancer patients.
authors.affiliation: Medical Oncology Unit 1, Istituto Oncologico Veneto-I.R.C.C.S., Padova, Italy. mauriziadp@gmail.com
authors.forename: Maurizia
authors.initials: M
authors.lastname: Dalla Palma
authors.forename: Michele
authors.initials: M
authors.lastname: Gregianin
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fiduccia
authors.forename: Laura
authors.initials: L
authors.lastname: Evangelista
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Cervino
authors.forename: Giorgio
authors.initials: G
authors.lastname: Saladini
authors.forename: Lucia
authors.initials: L
authors.lastname: Borgato
authors.forename: Maria Ornella
authors.initials: MO
authors.lastname: Nicoletto
authors.forename: Vittorina
authors.initials: V
authors.lastname: Zagonel
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018394:CA-125 Antigen / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008565:Membrane Proteins / Q000378:metabolism*; D064847:Multimodal Imaging / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18