Update of the role of PET/CT and PET/MRI in the management of patients with cervical cancer.
In cervical cancer (CC), fluorine18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) has been proven to be beneficial for patient management. Positron emission tomography/CT is useful in pretreatment evaluation due to the ability to evaluate disease extent and to assess regional lymph nodes as well as distant sites for metastases. Positron emission tomography/CT has an impact on treatment planning as well as it is incorporated in radiation therapy planning, resulting in more appropriate and effective treatment with less cost and radiation dose to normal tissues. Positron emission tomography/CT is used to predict early treatment response and to assess treatment response after completion of concurrent chemoradiation therapy. Positron emission tomography/CT has been used for surveillance after treatment as well as for restaging in suspected recurrent or metastatic disease. Qualitative PET/CT imaging findings as well as quantitative parameters such as maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) are useful to predict prognosis and clinical outcome. Moreover, PET imaging using other radiotracers to detect and quantify hypoxia may help to identify aggressive tumors and predict treatment outcome even though it is not widely clinical used. Positron emission tomography/magnetic resonance imaging (PET/MRI) instruments are now available, which may potentially improve evaluation of primary tumors and metastatic sites given the improved soft tissue contrast resolution of MRI relative to CT. This article reviews the role of18F-FDG PET/CT, hypoxia agent PET/CT, and18F-FDG PET/MRI in the management of patients with CC.
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. rkphulia@yahoo.com.
Benjapa
B
Khiewvan
Drew A
DA
Torigian
Sahra
S
Emamzadehfard
Koosha
K
Paydary
Ali
A
Salavati
Sina
S
Houshmand
Sara Pourhassan
SP
Shamchi
Thomas J
TJ
Werner
Aysel
A
Aydin
Shambo Guha
SG
Roy
Abass
A
Alavi
Rakesh
R
Kumar
D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18