18F-FDG PET/CT can predict nodal metastases but not recurrence in early stage uterine cervical cancer

A Comprehensive Comparison of CT, MRI, Positron Emission Tomography or Positron Emission Tomography/CT, and Diffusion Weighted Imaging-MRI for Detecting the Lymph Nodes Metastases in Patients with Cervical Cancer: A Meta-Analysis Based on 67 Studies

“…According to this study, MRI and PET/CT performed better in advanced stage cervical cancer patients than in early stage for detecting LN metastases. Two factors might account for this: 1 higher nodal metastases rate and 2 more frequent occurrences of bulky nodes, with macroscopic deposits of tumor, in advanced stage of the disease than in early stage [42] . Thus, the detection rates of PET/ CT and MRI were increased.…”

Primary tumor SUVmax on preoperative FDG-PET/CT is a prognostic indicator in stage IA2-IIB cervical cancer patients treated with radical hysterectomy

“…Kim et al (22) and Chung et al (26) reported that MTV was an independent prognostic factor for disease recurrence in patients with stage IA-IIB and IB-IIA, respectively. By contrast, the study by Crivellaro et al (21) showed that MTV and TLG were not predictors of recurrence in IB1-IIA (27) reported that TLG and the lymph node status, but not MTV, were independent prognostic factors for survival in stage IB-IVB. Considering the importance of intratumoral FDG metabolic heterogeneity (28), the present study focusing on the SUV max alone is simple, but may have limitations.…”

“…These different results may be due to treatment bias as disease stages and treatment modalities were diverse. When focusing on surgically-treated early-stage (FIGO stage IA or IB1 to IIA) cervical cancer, there have been controversial studies on the role of the SUV max (19,21,24). Lee et al (19) and Yun et al (24) showed that a high SUV max was correlated with impaired disease-free survival, while Crivellaro et al (21) showed that the SUV max was not associated with recurrence.…”

“…When focusing on surgically-treated early-stage (FIGO stage IA or IB1 to IIA) cervical cancer, there have been controversial studies on the role of the SUV max (19,21,24). Lee et al (19) and Yun et al (24) showed that a high SUV max was correlated with impaired disease-free survival, while Crivellaro et al (21) showed that the SUV max was not associated with recurrence. To clarify the prognostic impact of the SUV max on preoperative PET/CT, the present study focused on FIGO stage IA2 to IIB patients who had undergone the standardized surgical procedure (radical hysterectomy and pelvic lymphadenectomy) in a single institution.…”

“…In cervical cancer, previous studies have demonstrated the usefulness of PET/CT for the staging or assessment of lymph node metastasis (16,17). However, the correlation between the FDG uptake and clinicopathological outcome of the primary tumor has not yet been sufficiently studied and its prognostic impact remains controversial (18)(19)(20)(21). Furthermore, there have been few studies regarding the clinical impact of the preoperative SUV max in patients with early-stage (I-II) disease treated with radical hysterectomy (19,20,22).…”