Abstract
Aim Cervical cancer is one of the most common cancers of the female
reproductive system. The aim of the study was to assess the usefulness of the
18F-FDG-PET/CT study in staging of cervical cancer, with focus on
the primary tumor parameters.
Material & Methods 105 patients (mean age 56 ± 11y) with newly
diagnosed cervical cancer underwent PET/CT examination which was performed
60 min after IV injection of 18F-FDG with a mean activity of
364 ± 75MBq. 68 patients were diagnosed with stage IIIA/IIIB, 19 patients with
IIB, 10 patients with IB, 8 patients with stage IVA/IVB. Wilcoxon-Mann-Whitney
test and ROC curves were used for statistical analysis.
Results In 35 cases 18F-FDG-PET/CT did not show active
proliferative process outside the cervix. In 38 cases metastases were found in
iliac lymph nodes and in 32 patients scans showed metastases above the aortic
bifurcation including lymph nodes and other organs. The largest volumes of
primary tumor occurred in patients with distant metastases, while the lowest in
patients with disease limited only to cervix. In 63 % of the patients PET/CT
result was compatible with FIGO classification, in 20 % patients PET/CT result
showed less advanced disease and in 17 % of the patients PET/CT results were
higher than FIGO classification.
Conclusion PET/CT using 18F-FDG has an important impact on the
assessment of the stage of cervical cancer. In over 30 % of patients, this study
resulted in a radical change in the treatment plan.
Abstract
18F-FDG PET/CT quantitative techniques have been described as prognostic indicators in esophageal cancer. Objective: To evaluate the prognostic value of the maximal Standardized Uptake Value (SUVmax), the Metabolic Tumor Value (MTV) and the Total Lesion Glycolysis (TLG) measured in the primary tumor and in the suspicious lymph node.
Methods
A cohort study was performed to assess the association of SUVmax, MTV and TLG measured prior and post to neoadjuvant therapy, as well as the variation of these values between the two studies, with overall survival (OS) in patients with esophageal cancer submitted to trimodal therapy. The quantitative techniques were applied in the primary tumor (PT) and in the suspicious nodes (LN) by a nuclear medicine physician. The OS rates were analysed. Before neoadjuvant therapy, 106 patients had PET/CT, and 39 patients had post neoadjuvant PET/CT exams.
Results
Before neoadjuvant period all the variables related to LN were able to predict OS. MTV of primary (HR: 1.89; 95%CI: 1.01–3.52) tumor were also able to predict OS. On post neoadjuvant period and the variation pre-to-post neoadjuvant periods, none of the PET/CT variables related to LN were related to prognosis. All primary tumor volumetric variables were related to OS. MTV (HR: 4.66; 95%CI: 1.54–14.08) and TLG (HR: 4.86; 95%CI: 1.66–14.26) of PT of post neoadjuvant period; and the variation of MTV (HR: 2.95; 95%CI: 1.01–3.52) and TLG (HR: 3.49; 95%CI: 1.01–3.52) of the PT pre-to-post neoadjuvant periods were prognostic variables.
Conclusion
In patients with esophageal cancer, the burden of disease in the suspicious nodes and primary tumor prior to therapy and the residual burden of disease in PT in post therapy 18F-FDG PET/CT were associated with dismal prognosis.
18F-FDG PET/CT for detection of the primary tumor in adults with extracervical metastases from cancer of unknown primary