Skip to main content
SpringerLink
Log in

Gynecological Cancers

  • Protocol
  • First Online:
Positron Emission Tomography

Part of the book series: Methods in Molecular Biology ((MIMB,volume 727))

Abstract

The clinical problems raised in patients presenting with all forms of gynecological malignancy are currently addressed using conventional cross-sectional imaging, usually MRI. In general, F-18 FDG PET-CT has not been shown to have a clinical role in any of these cancers at presentation, although studies are under way to use this form of metabolic imaging to predict prognosis and the response to treatment. Although F-18 FDG PET-CT is superior to conventional imaging techniques, it is only moderately sensitive in demonstrating lymph node metastasis preoperatively, and is inadequate for local staging of patients with endometrial cancer. In ovarian cancer, F-18 FDG PET-CT provides an accurate assessment of the extent of disease, particularly in areas difficult to assess for metastases by CT and MRI such as the abdomen and pelvis, mediastinum, and supraclavicular region. F-18 FDG PET-CT is a sensitive method of detecting pelvic and para-aortic lymph nodal disease in cervical cancer, and appears to be superior to MRI and CT despite the limitations in identifying small foci of disease. In the main, as elsewhere in patients with cancer, the value of PET-CT is in identifying and defining the extent of recurrent disease, in distinguishing between posttreatment fibrosis and recurrence, and possibly in monitoring response to therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Protocol
USD 49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fletcher, J.W., Djulbegovic, B., Soares, H.P., Siegel, B.A., Lowe, V.J., Lyman, G.H., et al. (2008) Recommendations on the use of 18F-FDG PET in oncology J Nucl Med 49, 480–508.

    Article  PubMed  Google Scholar 

  2. Weber, W.A., Avril, N., Schwaiger, M. (1999) Relevance of positron emission tomography (PET) in oncology Strahlenther Onkol 175, 356–73.

    Article  PubMed  CAS  Google Scholar 

  3. Subhas, N., Patel, P.V., Pannu, H.K., Jacene, H.A., Fishman, E.K., Wahl, R.L. (2005) Imaging of pelvic malignancies with in-line F-18 FDG PET-CT: case examples and common pitfalls of FDG PET Radiographics 25, 1031–43.

    Article  PubMed  Google Scholar 

  4. Short, S., Hoskin, P., Wong, W. (2005) Ovulation and increased FDG uptake on PET: potential for a false-positive result Clin Nucl Med 30, 707.

    Article  PubMed  CAS  Google Scholar 

  5. Stahl, A., Weber, W.A., Avril, N., Schwaiger, M. (2000) Effect of N-butylscopolamine on intestinal uptake of fluorine-18-fluorodeoxyglucose in PET imaging of the abdomen Nuklearmedizin 39, 241–5.

    PubMed  CAS  Google Scholar 

  6. Barwick, T.D., Rockall, A.G., Barton, D.P., Sohaib, S.A. (2006) Imaging of endometrial adenocarcinoma Clin Radiol 61, 545–5.

    Article  PubMed  CAS  Google Scholar 

  7. Rockall, A.G., Sohaib, S.A., Harisinghani, M.G., Babar, S.A., Singh, N., Jeyarajah, A.R. (2005) Diagnostic performance of nanoparticle-enhanced magnetic resonance imaging in the diagnosis of lymph node metastases in patients with endometrial and cervical cancer J Clin Oncol 23, 2813–21.

    Article  PubMed  Google Scholar 

  8. Kitajima, K., Murakami, K., Yamasaki, E., Domeki, Y., Kaji, Y., Fukasawa, I., et al. (2008) Performance of integrated FDG PET/contrast-enhanced CT in the diagnosis of recurrent ovarian cancer: comparison with integrated FDG-PET/non-contrast-enhanced CT and enhanced CT Eur J Nucl Med Mol Imaging 35, 1439–48.

    Article  PubMed  Google Scholar 

  9. Nayot, D., Kwon, J.S., Carey, M.S., Driedger, A. (2008) Does preoperative positron emission tomography with computed tomography predict nodal status in endometrial cancer? A pilot study Curr Oncol 15, 123–5.

    PubMed  CAS  Google Scholar 

  10. Chung, H.H., Kang, W.J., Kim, J.W., Park, N.H., Song, Y.S., Chung, J.K., et al. (2008) The clinical impact of [(18)F]FDG PET-CT for the management of recurrent endometrial cancer: correlation with clinical and histological findings Eur J Nucl Med Mol Imaging 35, 1081–8.

    Article  PubMed  Google Scholar 

  11. Kim, S.K., Kang, K.W., Roh, J.W., Sim, J.S., Lee, E.S., Park, S.Y. (2005) Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle Eur J Nucl Med Mol Imaging 32, 757–63.

    Article  PubMed  CAS  Google Scholar 

  12. Hubner, K.F., McDonald, T.W., Niethammer, J.G., Smith, G.T., Gould, H.R., Buonocore, E. (1993) Assessment of primary and metastatic ovarian cancer by positron emission ­tomography (PET) using 2-[18F]deoxyglucose (2-[18F]FDG) Gynecol Oncol 51, 197–204.

    Article  PubMed  CAS  Google Scholar 

  13. Kumar, R., Alavi, A. (2004) PET imaging in gynecologic malignancies. Radiol Clin North Am 42, 1155–67, ix.

    Article  PubMed  Google Scholar 

  14. Fenchel, S., Grab, D., Nuessle, K., Kotzerke, J., Rieber, A., Kreienberg, R., et al. (2002) Asymptomatic adnexal masses: correlation of FDG PET and histopathologic findings Radiology 223, 780–8.

    Article  PubMed  Google Scholar 

  15. Yoshida, Y., Kurokawa, T., Kawahara, K., Tsuchida, T., Okazawa, H., Fujibayashi, Y., et al. (2004) Incremental benefits of FDG positron emission tomography over CT alone for the preoperative staging of ovarian cancer AJR Am J Roentgenol 182, 227–33.

    PubMed  Google Scholar 

  16. Kawahara, K., Yoshida, Y., Kurokawa, T., Suzuki, Y., Nagahara, K., Tsuchida, T., et al. (2004) Evaluation of positron emission tomography with tracer 18-fluorodeoxyglucose in addition to magnetic resonance imaging in the diagnosis of ovarian cancer in selected women after ultrasonography J Comput Assist Tomogr 28, 505–16.

    Article  PubMed  Google Scholar 

  17. De Rosa, V., Mangoni di Stefano, M.L., Brunetti, A., Caraco, C., Graziano, R., Gallo, M.S., et al. (1995) Computed tomography and second-look surgery in ovarian cancer patients. Correlation, actual role and limitations of CT scan Eur J Gynaecol Oncol 16, 123–9.

    PubMed  Google Scholar 

  18. Zimny, M., Siggelkow, W., Schroder, W., Nowak, B., Biemann, S., Rath, W., et al. (2001) 2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer Gynecol Oncol 83, 310–5.

    Article  PubMed  CAS  Google Scholar 

  19. Chang, W.C., Hung, Y.C., Kao, C.H., Yen, R.F., Shen, Y.Y., Lin, C.C. (2002) Usefulness of whole body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent ovarian cancer based on asymptomatically elevated serum levels of tumor marker Neoplasma 49, 329–33.

    PubMed  CAS  Google Scholar 

  20. Nakamoto, Y., Saga, T., Ishimori, T., Mamede, M., Togashi, K., Higuchi, T., et al. (2001) Clinical value of positron emission tomography with FDG for recurrent ovarian cancer AJR Am J Roentgenol 176, 1449–54.

    PubMed  CAS  Google Scholar 

  21. Picchio, M., Sironi, S., Messa, C., Mangili, G., Landoni, C., Gianolli, L., et al. (2003) Advanced ovarian carcinoma: usefulness of [(18)F]FDG-PET in combination with CT for lesion detection after primary treatment Q J Nucl Med 47, 77–84.

    PubMed  CAS  Google Scholar 

  22. Thrall, M.M., DeLoia, J.A., Gallion, H., Avril, N. (2007) Clinical use of combined positron emission tomography and computed tomography (FDG-PET-CT) in recurrent ovarian cancer Gynecol Oncol 105, 17–22.

    Article  PubMed  Google Scholar 

  23. Weber, W.A. (2006) Positron emission tomography as an imaging biomarker J Clin Oncol 24, 3282–92.

    Article  PubMed  CAS  Google Scholar 

  24. Avril, N.E., Weber, W.A. (2005) Monitoring response to treatment in patients utilizing PET Radiol Clin North Am 43, 189–204.

    Article  PubMed  Google Scholar 

  25. Avril, N., Sassen, S., Schmalfeldt, B., Naehrig, J., Rutke, S., Weber, W.A. (2005) Prediction of response to neoadjuvant chemotherapy by sequential F-18-fluorodeoxyglucose positron emission tomography in patients with advanced-stage ovarian cancer J Clin Oncol 23, 7445–53.

    Article  PubMed  Google Scholar 

  26. Miller, T.R., Grigsby, P.W. (2002) Measurement of tumor volume by PET to evaluate prognosis in patients with advanced cervical cancer treated by radiation therapy Int J Radiat Oncol Biol Phys 53, 353–9.

    Article  PubMed  Google Scholar 

  27. Belhocine, T., Thille, A., Fridman, V., Albert, A., Seidel, L., Nickers, P., et al. (2002) Contribution of whole-body (18)FDG PET imaging in the management of cervical cancer Gynecol Oncol 87, 90–7.

    Article  PubMed  Google Scholar 

  28. Narayan, K., Hicks, R.J., Jobling, T., Bernshaw, D., McKenzie, A.F. (2001) A comparison of MRI and PET scanning in surgically staged loco-regionally advanced cervical cancer: potential impact on treatment Int J Gynecol Cancer 11, 263–71.

    Article  PubMed  CAS  Google Scholar 

  29. Reinhardt, M.J., Ehritt-Braun, C., Vogelgesang, D., Ihling, C., Hogerle, S., Mix, M., et al. (2001) Metastatic lymph nodes in patients with cervical cancer: detection with MR imaging and FDG PET Radiology 218, 776–82.

    PubMed  CAS  Google Scholar 

  30. Xue, F., Lin, L.L., Dehdashti, F., Miller, T.R., Siegel, B.A., Grigsby, P.W. (2006) F-18 fluorodeoxyglucose uptake in primary cervical cancer as an indicator of prognosis after radiation therapy Gynecol Oncol 101, 147–51.

    Article  PubMed  CAS  Google Scholar 

  31. Grigsby, P.W., Siegel, B.A., Dehdashti, F. (2001) Lymph node staging by positron emission tomography in patients with carcinoma of the cervix J Clin Oncol 19, 3745–9.

    PubMed  CAS  Google Scholar 

  32. Tran, B.N., Grigsby, P.W., Dehdashti, F., Herzog, T.J., Siegel, B.A. (2003) Occult supraclavicular lymph node metastasis identified by FDG-PET in patients with carcinoma of the uterine cervix Gynecol Oncol 90, 572–6.

    Article  PubMed  Google Scholar 

  33. Singh, A.K., Grigsby, P.W., Dehdashti, F., Herzog, T.J., Siegel, B.A. (2003) FDG-PET lymph node staging and survival of patients with FIGO stage IIIb cervical carcinoma Int J Radiat Oncol Biol Phys 56, 489–93.

    Article  PubMed  Google Scholar 

  34. Sun, S.S., Chen, T.C., Yen, R.F., Shen, Y.Y., Changlai, S.P., Kao, A. (2001) Value of whole body 18F-fluoro-2-deoxyglucose positron emission tomography in the evaluation of recurrent cervical cancer Anticancer Res 21, 2957–61.

    PubMed  CAS  Google Scholar 

  35. Park, D.H., Kim, K.H., Park, S.Y., Lee, B.H., Choi, C.W., Chin, S.Y. (2000) Diagnosis of recurrent uterine cervical cancer: computed tomography versus positron emission tomography Korean J Radiol 1, 51–5.

    Article  PubMed  CAS  Google Scholar 

  36. Ryu, S.Y., Kim, M.H., Choi, S.C., Choi, C.W., Lee, K.H. (2003) Detection of early recurrence with 18F-FDG PET in patients with cervical cancer J Nucl Med 44, 347–52.

    PubMed  Google Scholar 

  37. Sakurai, H., Suzuki, Y., Nonaka, T., Ishikawa, H., Shioya, M., Kiyohara, H., et al. (2006) FDG-PET in the detection of recurrence of uterine cervical carcinoma following radiation therapy – tumor volume and FDG uptake value Gynecol Oncol 100, 601–7.

    Article  PubMed  Google Scholar 

  38. Nakamoto, Y., Eisbruch, A., Achtyes, E.D., Sugawara, Y., Reynolds, K.R., Johnston, C.M., et al. (2002) Prognostic value of ­positron emission tomography using F-18-fluorodeoxyglucose in patients with cervical cancer undergoing radiotherapy Gynecol Oncol 84, 289–95.

    Article  PubMed  Google Scholar 

  39. Grigsby, P.W., Siegel, B.A., Dehdashti, F. (2001) Lymph node staging by positron emission tomography in patients with carcinoma of the cervix J Clin Oncol 19, 3745–9.

    Article  PubMed  Google Scholar 

  40. Griffin, N., Grant, L.A., Sala, E. (2008) Magnetic resonance imaging of vaginal and vulval pathology Eur Radiol 18, 1269–80.

    Article  PubMed  CAS  Google Scholar 

  41. Ghurani, G.B., Penalver, M.A. (2001) An update on vulvar cancer Am J Obstet Gynecol 185, 294–9.

    Article  PubMed  CAS  Google Scholar 

  42. Sohaib, S.A., Richards, P.S., Ind, T., Jeyarajah, A.R., Shepherd, J.H., Jacobs, I.J., et al. (2002) MR imaging of carcinoma of the vulva AJR Am J Roentgenol 178, 373–7.

    PubMed  Google Scholar 

  43. Harisinghani, M.G., Saini, S., Weissleder, R., Hahn, P.F., Yantiss, R.K., Tempany, C., et al. (1999) MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic-pathologic correlation AJR Am J Roentgenol 172, 1347–51.

    PubMed  CAS  Google Scholar 

  44. Selman, T.J., Luesley, D.M., Acheson, N., Khan, K.S., Mann, C.H. (2005) A systematic review of the accuracy of diagnostic tests for inguinal lymph node status in vulvar cancer Gynecol Oncol 99, 206–14.

    Article  PubMed  CAS  Google Scholar 

  45. Imperiale, A., Heymann, S., Claria, M., Cimarelli, S., Sellem, D.B., Goetz, C., et al. (2007) F-18 FDG PET-CT in a rare case of Bartholin’s gland undifferentiated carcinoma managed with chemoradiation and interstitial brachytherapy Clin Nucl Med 32, 498–500.

    Article  PubMed  Google Scholar 

  46. Husain, A., Akhurst, T., Larson, S., Alektiar, K., Barakat, R.R., Chi, D.S. (2007) A prospective study of the accuracy of 18Fluorodeoxyglucose positron emission tomography (18FDG PET) in identifying sites of metastasis prior to pelvic exenteration Gynecol Oncol 106, 177–80.

    Article  PubMed  CAS  Google Scholar 

  47. De Hullu, J.A., Pruim, J., Que, T.H., Aalders, J.G., Boonstra, H., Vaalburg, W., et al. (1999) Noninvasive detection of inguinofemoral lymph node metastases in squamous cell cancer of the vulva by L Int J Gynecol Cancer 9, 141–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Barts and The London School of Medicine, Queen Mary, University of London, London, UK

    Norbert Avril

  2. Centre for Cancer Imaging, University Hospital of Heraklion, Medical School of Crete, Crete, Greece

    Sofia Gourtsoyianni

  3. Centre for Cancer Imaging, Chelsea and Westminster Hospital, London, UK

    Rodney Reznek

Authors
  1. Norbert Avril
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sofia Gourtsoyianni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rodney Reznek
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Norbert Avril .

Editor information

Editors and Affiliations

  1. Dept. Radiology, University of Iowa, Hawkins Drive 200, Iowa City, 52242-1009, Iowa, USA

    Malik E. Juweid

  2. , Dept. Nuclear Medicine & PET Research, VU University Medical Centre, De Boelelaan 1117, Amsterdam, 1081 HV, Netherlands

    Otto S. Hoekstra

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Humana Press

About this protocol

Cite this protocol

Avril, N., Gourtsoyianni, S., Reznek, R. (2011). Gynecological Cancers. In: Juweid, M., Hoekstra, O. (eds) Positron Emission Tomography. Methods in Molecular Biology, vol 727. Humana Press. https://doi.org/10.1007/978-1-61779-062-1_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-61779-062-1_10

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-61779-061-4

  • Online ISBN: 978-1-61779-062-1

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics

Search

Navigation