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European Journal of Nuclear Medicine and Molecular Imaging

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01-12-2006 | Original article

Comparative benefits and limitations of ¹⁸F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer

Authors: Tzu-Chen Yen, Chyong-Huey Lai, Shih-Ya Ma, Kuan-Gen Huang, Huei-Jean Huang, Ji-Hong Hong, Swei Hsueh, Wuu-Jyh Lin, Koon-Kwan Ng, Ting-Chang Chang

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2006

Abstract

Purpose

The purpose of this study was to assess the comparative benefits and limitations of ¹⁸F-fluorodeoxyglucose (FDG) PET and CT-MRI in documented or suspected recurrence of cervical cancer after primary treatment.

Methods

Three patient groups were enrolled. Group A patients had biopsy-documented recurrent or persistent cervical cancer. Group B patients had suspicion of recurrent tumour on CT-MRI without biopsy proof and were potentially curable. Group C patients were in complete remission after previous definitive treatment for histologically confirmed cervical carcinoma but had elevated serum squamous cell carcinoma antigen (tumour marker) levels despite negative CT-MRI. Clinical management decisions were recorded with CT-MRI alone and with additional FDG PET. Discordances and concordances between CT-MRI and FDG PET results were identified and related to final diagnosis as based on histopathology or follow-up.

Results

A total of 150 patients (ten regions per patient) were eligible for analysis, with 58 in group A, 52 in group B and 40 in group C. For the 149 discordant regions, 126 (84.6%) had final diagnoses. Of these final diagnoses, there was additional benefit from FDG PET over CT-MRI in 73.8% (93/126), with FDG PET correcting false negatives (FNs) on CT-MRI in 74.2% (69/93) and correcting false positives (FPs) on CT-MRI in 25.8% (24/93). Among lesions confirmed by FDG PET, 75.4% (52/69) were extra-pelvic. There was additional benefit of CT-MRI compared with FDG PET in 26.2% (33/126): in nine (27.3%) CT-MRI results were shown to be true positive (TP) whereas FDG PET yielded FN results, while in 24 (72.7%) CT-MRI corrected FP results on FDG PET. Among the nine FNs on FDG PET that were identified by CT-MRI, four were extra-pelvic. Among the FPs on FDG PET that were excluded by CT-MRI, 79.2% (19/24) were extra-pelvic.

Conclusion

For recurrent cervical cancer, the benefits of FDG PET exceed those of CT-MRI owing to the ability of FDG PET to identify extra-pelvic metastases and its higher sensitivity and specificity.

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Title: Comparative benefits and limitations of 18F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer
Authors: Tzu-Chen Yen
Chyong-Huey Lai
Shih-Ya Ma
Kuan-Gen Huang
Huei-Jean Huang
Ji-Hong Hong
Swei Hsueh
Wuu-Jyh Lin
Koon-Kwan Ng
Ting-Chang Chang
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2006
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0090-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative benefits and limitations of ¹⁸F-FDG PET and CT-MRI in documented or suspected recurrent cervical cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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