title: Diffusion-weighted MRI and 18F-FDG-PET/CT imaging: competition or synergy as diagnostic methods to manage sarcoma of the uterus? A systematic review of the literature.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of fluorine-18-fluorodeoxyglucose PET/computed tomography (F-FDG-PET/CT) and MRI with diffusion-weighted images (DWI) in uterine sarcomas (US).
  
  
  METHODS
  A systematic review was performed on Medline, ISI web of knowledge, and Scopus databases for studies reporting the diagnostic performance of F-FDG-PET/CT and DWI-MRI in US published up to 15 February 2016. Exclusion criteria were articles with fewer than five cases of US, without DWI-MRI, and previous series of patients from the same researcher team.
  
  
  RESULTS
  Seven studies were selected for DWI-MRI and 11 for F-FDG-PET/CT. DWI-MRI was used only to characterize uterine tumors, and showed a good sensitivity but a low specificity. The apparent diffusion coefficient value seems to be the most discriminant between benign and malignant lesion. No data were available on staging and restaging.F-FDG-PET/CT improved patients' management when used for characterization, staging, and restaging because of its quite good accuracy. To date, few data exist on the prognostic role of F-FDG-PET/CT. Well-designed multicenter prospective trials are needed to establish definitively the exact role of imaging in the management of US.
  
  
  CONCLUSIONS
  Both DWI-MRI and F-FDG-PET/CT have their own advantages, and should be performed in a 'one stop shop' scan in the near future by PET/MRI engines.
authors.affiliation: aNuclear Medicine and PET Unit, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite bEquipe Mixte de Recherche 3738, Université Claude Bernard Lyon 1, Lyon cNuclear Medicine Department, Groupement Hospitalier Est, Hospices Civils de Lyon 59, Bron, France dDepartment of Nuclear Medicine, Radiology, Neuroradiology, Medical Physics, Laboratory, Microbiology, and Pathology, Santa Maria della Misericordia Hospital, Rovigo, Italy.
authors.forename: Julien
authors.initials: J
authors.lastname: Dubreuil
authors.forename: Jeremie
authors.initials: J
authors.lastname: Tordo
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Francesco
authors.initials: F
authors.lastname: Giammarile
authors.forename: Andrea
authors.initials: A
authors.lastname: Skanjeti
mesh_terms: D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012509:Sarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18