Evaluation of Gynecologic Cancer with MR Imaging, <sup>18</sup>F-FDG PET/CT, and PET/MR Imaging

Lee, Susanna I.; Catalano, Onofrio A.; Dehdashti, Farrokh

doi:10.2967/jnumed.114.145011

Cited by 95 publications

(50 citation statements)

References 57 publications

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“…10 Therefore, FDG PET/CT may be helpful for assessment of the tumor grade. This case indicates uterine lymphoma should be included in the differential diagnosis of abnormal uterine FDG accumulation along with physiological endometrial uptake, 11 postpartum uterus, 12 adenomyosis, 13,14 endometrial hyperplasia, 14 leiomyoma, 14,15,16 cervical cancer, 14,17 endometrial cancer, 14,18 choriocarcinoma, 19 uterine sarcoma, 14,16,20 and uterine metastasis. 14,21 …”

Section: Discussionmentioning

confidence: 89%

Primary Uterine Peripheral T-cell Lymphoma

Gong¹,

Dong

Wei³

et al. 2016

Medicine

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Primary uterine non-Hodgkin's lymphoma is extremely rare accounting for <1% of all extranodal non-Hodgkin's lymphomas. Imaging findings of primary uterine lymphoma have rarely been reported before. We present magnetic resonance imaging (MRI) and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in a patient with primary uterine peripheral T-cell lymphoma.A 27-year-old female presented with intermittent fever with neutropenia for 7 months. MRI showed an ill-defined mass involved both the uterine corpus and cervix, resulting in diffuse enlargement of the uterus. This mass showed inhomogeneous hypointensity on unenhanced T1-weighted images, hyperintensity on diffusion-weighted imaging, relative hypointensity compared to the surrounding myometrium on T2-weighted images and lower enhancement than the surrounding myometrium on enhanced T1-weighted images. FDG PET/CT showed intense FDG uptake in the thickened wall of the uterine corpus and cervix with SUVmax of 26.9. There were multiple hypermetabolic lymph nodes in the pelvis and retroperitoneum. Uterine curettage and CT-guided biopsy of the uterine mass revealed peripheral T-cell lymphoma. Bone marrow biopsy revealed no evidence of lymphomatous involvement. The imaging and pathologic findings were consistent with primary uterine lymphoma. After 3 circles of chemotherapy, follow-up enhanced MRI showed decreased thickness of the uterine wall.Despite its rarity, primary uterine non-Hodgkin's lymphoma should be taken into consideration when a uterine tumor shows large size, relative hypointesity on both T2-weighted images and enhanced T1-weighted images compared to the surrounding myometrium, and intense FDG uptake on PET/CT. MRI may be helpful for describing the relationship between the tumor and adjacent structures. FDG PET/CT may be useful for tumor detection and staging.

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Section: Discussionmentioning

confidence: 89%

Primary Uterine Peripheral T-cell Lymphoma

Gong¹,

Dong

Wei³

et al. 2016

Medicine

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“…MR imaging has been demonstrated very accurate for the detection of parametrial invasion and the exclusion of bladder or rectal invasion, representing two important determinants for the correct selection of the appropriate initial treatment [5]. With increasing introduction of hybrid imaging techniques for oncologic imaging, PET/CT and PET/MRI have become the focus of interest in the past years for the evaluation of gynecological cancers [19]. A recent publication by Kitajima et al investigated the diagnostic value of retrospectively fused PET and MRI datasets for T-and N-staging of primary cervical cancers [20].…”

Section: Discussionmentioning

confidence: 99%

Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

Grueneisen

Schaarschmidt

Heubner

et al. 2015

Eur J Nucl Med Mol Imaging

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“…Since then, huge progress has been made regarding methodological approaches and technical versatility (27)(28)(29). At present, three major companies specializing in imaging hardware offer PET/MRI with various system designs (30).…”

Section: Discussionmentioning

confidence: 99%

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

et al. 2018

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Abstract. The current study aimed to determine the optimum diagnostic imaging technique out of magnetic resonance imaging (MRI), 18 F-f ludeoxyglucose positron emission tomography/computed tomography ([ 18 F] FDG-PET/CT, otherwise known as PET/CT) and [18 F] FDG-PET/MRI (otherwise known as PET/MRI) for the pelvic lymph node staging (N-staging) of untreated cervical carcinoma (CC). A total of 27 patients were included in the present study. All patients had undergone pre-treatment with PET/CT and MRI ≤45 days prior to undergoing a lymphadenectomy. The results from PET (separated from PET/CT), MRI and the statistically combined results of (virtual) PET/MRI were compared to those from histological analyses (the gold standard). A per-patient-based analysis of the detection of pelvic lymph node metastases indicated that PET/MRI had a sensitivity of 64%. The specificity of PET/CT and MRI were 69 and 62%, respectively. The positive predictive value (PPV) was 69 and 64% for PET/CT and MRI, respectively. The negative predictive value (NPV) was 64 and 62% for PET/CT and MRI, respectively. The sensitivity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 64% for both. The specificity of the PET-guided PET/MRI and the MRI-guided PET/MRI was 77 and 62%, respectively. The PPV was 75% for PET-guided PET/MRI and 64% for MRI-guided PET/MRI, and the NPV was 67 and 62%, respectively. PET/CT and the virtual PET/MRI exhibited the same low sensitivity (64%). PET/MRI exhibited slightly better results than PET/CT regarding specificity (77 vs. 69%, respectively), PPV (75 vs. 69%, respectively) and NPV (67 vs. 64%, respectively). The results of the present study suggested that PET/CT and MRI are not optimal diagnostic modalities, and that PET/MRI does not necessarily lead to better results than PET/CT, in the pelvic N-staging of CC.

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Evaluation of Gynecologic Cancer with MR Imaging, ¹⁸F-FDG PET/CT, and PET/MR Imaging

Cited by 95 publications

References 57 publications

Primary Uterine Peripheral T-cell Lymphoma

Primary Uterine Peripheral T-cell Lymphoma

Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

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Evaluation of Gynecologic Cancer with MR Imaging, 18F-FDG PET/CT, and PET/MR Imaging

Cited by 95 publications

References 57 publications

Primary Uterine Peripheral T-cell Lymphoma

Primary Uterine Peripheral T-cell Lymphoma

Integrated PET/MRI for whole-body staging of patients with primary cervical cancer: preliminary results

[18F]FDG-PET/CT and MRI for initial pelvic lymph node staging in patients with cervical carcinoma: The potential usefulness of [18F]FDG-PET/MRI

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Evaluation of Gynecologic Cancer with MR Imaging, ¹⁸F-FDG PET/CT, and PET/MR Imaging