Detection of recurrent cervical cancer by whole-body FDG PET scan in asymptomatic and symptomatic women

Unger, James B.; Ivy, Joseph J.; Connor, Patrick M.; Charrier, A.; Ramaswamy, Mohan; Ampil, Federico L.; Monsour, Richard P

doi:10.1016/j.ygyno.2004.04.021

Cited by 80 publications

(40 citation statements)

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“…Unfortunately, most recurrences can not be diagnosed early. The purpose of this study was to investigate the usefulness of PET scan imaging in the early detection of recurrent disease in patients previously treated for cervical cancer [7][8][9] . Unfortunately, women with symptomatic recurrent cervical cancer have limited treatment options and often do not survive their disease.…”

Section: Discussionmentioning

confidence: 99%

Detection of recurrent cervical cancer by whole-body FDG PET scans

Yang

Wang

Zhu

et al. 2008

Chin. J. Clin. Oncol.

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OBJECTIVE To evaluate the role of whole-body { 18 F}fluro-2-dexoxyglucose (FDG) positron emission tomography (PET) scans in the detection of recurrent cervical cancer. METHODS Between June, 2000 and January, 2006, 25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer. All the PET fi ndings were reviewed and compared to available clinical data to classify each PET scan result as a true positive, true negative, false positive, or false negative. RESULTS A total of 38 PET scans were conducted on the 25 patients whose median age was 46 years. The Stage distributions were IA (n = 1), IB (n = 11), IIA (n = 5), IIB (n = 4), IIIB (n = 2), IVB (n = 1), and unknown Stage (n = 1). There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans, 27 true negatives, 2 false positives and no false negatives. The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%, specificity 93.1%, positive predictive value 81.8%, and negative predictive value 100%. CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer. However the cost of PET scans is too high at this time. A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical carcinoma KEY WORDS: tomography, emission-computed, positron, 18 F-fl uorodeoxyglucose, recurrent cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Detection of recurrent cervical cancer by whole-body FDG PET scans

Yang

Wang

Zhu

et al. 2008

Chin. J. Clin. Oncol.

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“…Therefore, FDG-PET/CT has important implications and may be more valuable for the detection of early recurrence than CT or MRI, especially when incorporating standardized uptake values, though post-radiation infl ammation can make interpretation of FDG-PET/CT diffi cult in the immediate post-treatment period, or in patients with fi stulas or other infectious processes. Additionally, patients concerned with symptoms of recurrent disease have a signifi cantly higher chance of having recurrent disease detected by PET compared with their asymptomatic counterparts [34,35]. PET may allow earlier detection of local recurrences that may be salvaged with pelvic exenteration, whereas sparing those patients with disease elsewhere the morbidity of the procedure for little survival advantage [32,36,37].…”

Section: Pet Imaging In Cervical Cancermentioning

confidence: 99%

“…Unger et al [35] reported results in patients undergoing follow-up FDG-PET. Recurrent disease was present in 30.8% of 26 patients undergoing PET for surveillance compared with 66.7% of 21 symptomatic patients.…”

Section: Pet Imaging In Cervical Cancermentioning

confidence: 99%

“…Recurrence was also detected 5 months earlier in symptomatic compared with asymptomatic patients who underwent FDG-PET for surveillance only, though this was not statistically signifi cant. Sensitivity for detecting recurrence was 80% in asymptomatic patients and 100% in symptomatic patients, whereas specifi city was 100% in asymptomatic patients and 86% in symptomatic ones [35]. The use of FDG-PET has recently been evaluated in detecting asymptomatic recurrences in cervical cancer patients.…”

Section: Pet Imaging In Cervical Cancermentioning

confidence: 99%

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Novel imaging modalities in gynecologic cancer

Brooks¹,

Powell

2009

Curr Oncol Rep

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Novel imaging modalities continue to emerge in medicine, and the advent of (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) has had a significant impact in the imaging of gynecologic malignancies. In cervical cancer, FDG-PET has excellent sensitivity and specificity for evaluation of initial disease, as well as assessment of post-treatment response and long-term surveillance. In ovarian cancer, FDG-PET can be a useful tool in assessing recurrent disease, especially in the setting of a rising cancer antigen-125 with a negative or equivocal CT or MRI. In uterine cancer, FDG-PET has been investigated in evaluating the extent of disease including nodal metastases, and in assessing recurrence. This article reviews novel imaging modalities in gynecologic cancer, with a special focus on FDG-PET/CT.

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“…L'examen a pu diagnostiquer la récidive avec une Se de 80 %, une Sp de 100 %, une VPP de 100 % et une VPN de 89 %. Vingtet-une TEP-FDG ont été réalisées chez des patientes symptomatiques, les performances de l'examen étaient respectivement de 100, 86, 93 et 100 % [66].…”

Section: Cancer Du Col Et Du Corps Utérinunclassified