An appraisal of 18F-FDG PET imaging in post-therapy surveillance of uterine cancers: Clinical evidence and a research proposal

Despite important advances in screening for preinvasive forms of uterine cancers and more efficient combined therapy modalities, the surveillance of women previously treated either for a cervical or an endometrial cancer remains problematic. The follow-up protocols commonly applied in practice usually include a physical examination at control visits and clinically oriented morphologic imaging procedures. These routine protocols are, however, not standardized. Moreover, their sensitivity for accurately detecting a recurrent disease is most often suboptimal, especially in asymptomatic patients. On the other hand, the performances of a high-technology imaging such as positron emission tomography (PET) using 18F-fluoro-2-deoxy-D-glucose (18FDG) are nowadays firmly established in the post-treatment monitoring of oncology patients. The purpose of the present paper is to review both the advantages and the limitations of 18FDG PET imaging in the surveillance of women previously treated for uterine cancers. Based on the encouraging literature data, a well-designed research protocol is proposed in order to more objectively assess the contribution of metabolic imaging in the post-therapy management of these gynecological malignancies.