The role of positron emission tomography in the selection of patients for salvage hysterectomy following chemoradiotherapy for locally advanced cervical cancer

BackgroundPatients selection for salvage hysterectomy following chemoradiotherapy of cervical cancer is vital to avoid significant morbidity. The purpose of this study was to describe the role of post-treatment F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scanning (FDG-PET/CT) in patient selection for salvage hysterectomy.MethodsThis was a retrospective analysis of 49 patients with cervical cancer treated between January 1996 and December 2012 who were candidates for salvage hysterectomy.ResultsThree groups were defined based on institutional treatment guidelines, as experience in using post-treatment FDG-PET/CT to guide management evolved. Group 1 consisted of 15 patients who underwent planned hysterectomy based on clinical, cytological, or histological suspicion. Of these, only three (20%) patients had residual disease on histology. Group 2 consisted of 13 patients who had post-treatment FDG-PET/CT 3–6 months after the completion of chemoradiotherapy due either to suspicion of recurrence on examination or patients thought to be at high risk of recurrence at the primary site. Of these, eight patients had hysterectomy and four patients showed positive histology for residual tumor. Group 3 had 21 patients who showed isolated FDG uptake at the primary site on first FDG-PET/CT scanning at 6 months. A subsequent FDG-PET/CT scan after 3 months showed disease progression in seven and complete metabolic response in 14, and surgery was avoided in all patients.ConclusionFDG-PET/CT scanning at 6 months after radiotherapy is a good tool for assessing treatment response in patients with cervical cancer. In patients with persistent uptake on 6 months post-treatment FDG-PET/CT, repeat imaging at a 3-month interval helps in selecting patients for salvage hysterectomy.

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Predictive role of post-treatment [18F]FDG PET/CT in patients with uterine cervical cancer

European Journal of Radiology ◽

10.1016/j.ejrad.2012.02.015 ◽

2012 ◽

Vol 81 (8) ◽

pp. e817-e822 ◽

Cited By ~ 14

Author(s):

Hyun Hoon Chung ◽

Jae Weon Kim ◽

Keon Wook Kang ◽

Noh-Hyun Park ◽

Yong-Sang Song ◽

...

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Uterine Cervical Cancer ◽

Post Treatment ◽

Pet Ct ◽

Predictive Role ◽

18F Fdg ◽

Fdg Pet Ct

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Molecular imaging and immunotherapy

The International Journal of Biological Markers ◽

10.1177/1724600819899099 ◽

2020 ◽

Vol 35 (1_suppl) ◽

pp. 37-41

Author(s):

Laura Evangelista

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Positron Emission Tomography ◽

Clinical Practice ◽

Fdg Pet ◽

Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

The utility of positron emission tomography (PET) for the evaluation of response to immunotherapy has been considered a hot topic, particularly in the last 2 to 3 years. Different experiences have been collected in clinical practice, with 18F-Fluorodeoxyglucose (FDG) PET/computed tomography (CT), particularly in patients affected by lymphoma, malignant melanoma, and lung cancer. It has been tested in different settings of disease, from the prediction to the prognosis relative to the response to immunotherapy. In the present mini-review, some evidence is reported about the role of FDG PET/CT in patient candidates to or treated with immunotherapy.

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Histologic Results of Para-Aortic Lymphadenectomy in Patients Treated for Stage IB2/II Cervical Cancer With Negative [18F]Fluorodeoxyglucose Positron Emission Tomography Scans in the Para-Aortic Area

Journal of Clinical Oncology ◽

10.1200/jco.2007.14.3933 ◽

2008 ◽

Vol 26 (15) ◽

pp. 2558-2561 ◽

Cited By ~ 69

Author(s):

Mathias Boughanim ◽

Sophie Leboulleux ◽

Annie Rey ◽

Chi Tuan Pham ◽

Yaelle Zafrani ◽

...

Keyword(s):

Cervical Cancer ◽

Fdg Pet ◽

Emission Tomography ◽

Fluorodeoxyglucose Positron Emission Tomography ◽

Nodal Involvement ◽

Positron Emission ◽

Pet Ct ◽

Aortic Area ◽

Fdg Pet Ct ◽

Fluorodeoxyglucose Positron Emission

Purpose Histologic results of complete para-aortic lymphadenectomy were studied in patients treated for stage IB2/II cervical carcinoma who had no para-aortic uptake on [18F]fluorodeoxyglucose positron emission tomography combined with integrated computed tomography (FDG-PET/CT). Patients and Methods Patients were treated between 2004 and 2006 for stage IB2/II cervical cancer. Magnetic resonance imaging of the abdomen and pelvis and FDG-PET/CT were initially performed. Patients with no para-aortic abnormalities were treated with external pelvic radiation therapy and concomitant chemotherapy followed by utero-vaginal brachytherapy. Para-aortic lymphadenectomy was then performed. FDG-PET/CT images were reviewed by two nuclear medicine specialists. Results Thirty-eight patients were studied. Three patients had histologically proven para-aortic involvement (metastatic nodes with capsular rupture in the para-aortic area), leading to a negative predictive value of 92% for para-aortic nodal involvement. Conclusion In this study, three of 38 patients with no para-aortic uptake on [18F]FDG-PET/CT imaging had histologically proven para-aortic node involvement. PET/CT imaging without histologic examination of the para-aortic area used to determine radiation therapy fields in stage IB2/II cervical cancer would overlook 8% of patients with histologic para-aortic nodal involvement.

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Prognostic Impact of Pretreatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography SUVmax in Patients With Locally Advanced Cervical Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001207 ◽

2018 ◽

Vol 28 (3) ◽

pp. 575-580 ◽

Cited By ~ 10

Author(s):

Simona Cima ◽

Anna Myriam Perrone ◽

Paolo Castellucci ◽

Gabriella Macchia ◽

Milly Buwenge ◽

...

Keyword(s):

Cervical Cancer ◽

Primary Tumor ◽

Fdg Pet ◽

Locally Advanced ◽

Emission Tomography ◽

Advanced Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

ObjectiveThe aim of this study was to investigate the impact of SUVmax fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) measured in the primary tumor, pelvic and para-aortic node with disease-free survival (DFS) and overall survival (OS) in patients with locally advanced cervical cancer.Methods and MaterialsA total of 92 patients with histological diagnosis of locally advanced cervical cancer are treated with radiochemotherapy plus brachytherapy boost from January 2008 to April 2014 in our Institution. A pretreatment FDG-PET/CT for staging and radiotherapy planning was performed, and the value of SUVmax measured in primary tumor and positive nodes was related to DFS and OS.ResultsUnivariate analysis showed that DFS is related to FDG-PET/CT positive para-aortic nodes (P = 0.01), International Federation of Gynecology and Obstetrics (FIGO) stage of disease (P = 0.01), and primary tumor SUVmax (P = 0.02), and OS is related to positive para-aortic nodes (P = 0.01) and primary tumor SUVmax (P = 0.02).In multivariate analysis, DFS is modified by FDG-PET/CT positive para-aortic lymph nodes, stage and high T SUVmax (P = 0.02; P = 0.003; P = 0.04), but the only worse prognostic factor of OS is the high SUVmax in the primary tumor (P = 0.01).ConclusionsWe found that T SUVmax, stage, and para-aortic lymph node status assessed by FDG-PET were independent prognostic factors of DFS, whereas only T SUVmax correlated with OS.

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The Role of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography in Assessing the Response to Neoadjuvant Treatment in Patients with Osteosarcoma

International Journal of Molecular Imaging ◽

10.1155/2012/870301 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Carmelo Caldarella ◽

Marco Salsano ◽

Maria Antonietta Isgrò ◽

Giorgio Treglia

Keyword(s):

Positron Emission Tomography ◽

Fdg Pet ◽

Neoadjuvant Treatment ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Fluorine 18 Fluorodeoxyglucose

Aim. The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with fluorine-18-fluorodeoxyglucose (FDG) in assessing the response to neoadjuvant treatment in patients with osteosarcoma (OS). Methods. A comprehensive literature search of published studies through March 2012 in PubMed/MEDLINE, Embase, and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. Results. Twenty-two studies have investigated the role of FDG-PET and FDG-PET/CT in the evaluation of response to neoadjuvant treatment with either chemotherapy or radiation therapy in patients with OS. The main findings of these studies are presented. Conclusion. FDG-PET or PET/CT seems to be sensitive and reliable diagnostic tools in the assessment of metabolic response to treatment in patients with OS, after baseline PET evaluation has been performed in advance. However, false positive findings due to inflammation in sites of tumoral response should be considered.

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The role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography in the differential diagnosis of pericardial disease

Scientific Reports ◽

10.1038/s41598-020-78581-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Cheol Won Hyeon ◽

Hyun Kyung Yi ◽

Eun Kyoung Kim ◽

Sung-Ji Park ◽

Sang-Chol Lee ◽

...

Keyword(s):

Differential Diagnosis ◽

Fdg Pet ◽

Diagnostic Yield ◽

Emission Tomography ◽

Pericardial Disease ◽

Fdg Uptake ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

AbstractThis study aimed to assess the role of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) in the differential diagnosis of pericardial disease. The diagnosis is often troublesome because pericardial fluid analysis or biopsy does not always provide answers. 18FDG-PET/CT can visualize both inflammation and malignancy and offers a whole-body assessment. Patients who visited the Pericardial Disease Clinic of Samsung Medical Center with an 18FDG-PET/CT order code were extracted. Exclusion criteria were as follows: (1) the purpose of the differential diagnosis was not pericardial disease; (2) the patient had a known advanced-stage malignancy; (3) the patient already have confirmative diagnosis using a serology, pericardial effusion analysis or biopsy. The analysis included 107 patients. The most common final diagnosis was idiopathic (n = 46, 43.0%), followed by tuberculosis (n = 30, 28.0%) and neoplastic (n = 11, 10.3%). A maximum standardized uptake value (SUVmax) ≥ 5 typically indicates tuberculosis or neoplastic pericarditis except in just one case of autoimmune pericarditis); especially all of the SUVmax scores ≥ 10 had tuberculosis. The diagnostic yield of pericardial biopsy was very low (10.2%). Interestingly, all of the pericardium with an SUVmax < 4.4 had nondiagnostic results. In contrast, targeted biopsies based on 18FDG uptake demonstrated a higher diagnostic yield (38.7%) than pericardium. The sensitivity of 18FDG-PET/CT was 63.6%. The specificity was 71.9%. The positive predictive value was 20.6%. The negative predictive value 94.5%, and the accuracy was 71.0% for excluding malignancy based upon the FDG uptake patterns. It is possible to explore the differential diagnosis in some patients with difficult pericardiocentesis or pericardial biopsy in a noninvasive manner using on the SUVmax or uptake patterns. In addition, the biopsy strategy depending on 18FDG uptake is helpful to achieve biopsy more safely and with a higher yield. 18FDG-PET may enhance the diagnostic efficacy in patients with pericardial disease.

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Role of 2-[18F]FDG as a Radiopharmaceutical for PET/CT in Patients with COVID-19: A Systematic Review

Pharmaceuticals ◽

10.3390/ph13110377 ◽

2020 ◽

Vol 13 (11) ◽

pp. 377

Author(s):

Salvatore Annunziata ◽

Roberto C. Delgado Bolton ◽

Christel-Hermann Kamani ◽

John O. Prior ◽

Domenico Albano ◽

...

Keyword(s):

Systematic Review ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Emission Tomography ◽

Evidence Based ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Some recent studies evaluated the role of fluorine-18 fluorodeoxyglucose (2-[18F]FDG) as a radiopharmaceutical for positron emission tomography/computed tomography (PET/CT) imaging in patients with Coronavirus Disease (COVID-19). This article aims to perform a systematic review in this setting. A comprehensive computer literature search in PubMed/MEDLINE and Cochrane library databases regarding the role of 2-[18F]FDG PET/CT in patients with COVID-19 was carried out. This combination of key words was used: (A) “PET” OR “positron emission tomography” AND (B) “COVID” OR “SARS”. Only pertinent original articles were selected; case reports and very small case series were excluded. We have selected 11 original studies of 2-[18F]FDG PET/CT in patients with COVID-19. Evidence-based data showed first preliminary applications of this diagnostic tool in this clinical setting, with particular regard to the incidental detection of interstitial pneumonia suspected for COVID-19. To date, according to evidence-based data, 2-[18F]FDG PET/CT cannot substitute or integrate high-resolution CT to diagnose suspicious COVID-19 or for disease monitoring, but it can only be useful to incidentally detect suspicious COVID-19 lesions in patients performing this imaging method for standard oncological and non-oncological indications. Published data about the possible role of 2-[18F]FDG PET/CT in patients with COVID-19 are increasing, but larger studies are warranted.

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Role of integrated F-18 fluoro-deoxy-glucose positron emission tomography and computed tomography in evaluation of lung cancer

Archive of oncology ◽

10.2298/aoo1204107s ◽

2012 ◽

Vol 20 (3-4) ◽

pp. 107-111

Author(s):

Dragana Sobic-Saranovic

Keyword(s):

Lung Cancer ◽

Fdg Pet ◽

Small Cell ◽

Emission Tomography ◽

Small Cell Lung ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct

Lung cancer is one of the leading causes of death in the world. It is generally divided in two groups: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Positron emission tomography (PET)/CT using the glucose analogue labeled with 18-fluor (F-18): fluoro-deoxy-glucose (F-18-FDG), is unique integrated imaging modality that offers simultaneous anatomic and metabolic information valuable in the diagnosis, staging and follow-up of both types of lung cancer and in particular in NSCLC. FDG accumulation in tissue is proportional to the amount of glucose utilization. Increased consumption of glucose is a characteristic of almost all types of lung cancer except in bronchoalveolar carcinoma and well differentiated neuroendocrine tumors. The objective of this brief review is to highlight the clinical role of F-18-FDG PET/CT in detection, staging, re-staging, and assessment of therapy response and follow up in lung cancer. The performance of F-18-FDG PET/CT in specific clinical situations is of special interest: in the differentiation of indeterminate lung lesions, the staging of NSCLC for lymph node and extra thoracic metastases, for therapy planning, the detection of recurrent lung cancer and the use in SCLC. In conclusion, F-18-FDG PET/CT helps in characterization of suspicious lesions, provides more precise staging of NSCLC than other imaging techniques, allows better patients? selection for new modalities of treatment, helps in restaging after induction therapy, allows better delineation for radiotherapy planning and helps in follow up evaluation by differentiating residual or recurrent tumor from post treatment scar.

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The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma

Radiology and Oncology ◽

10.2478/raon-2013-0017 ◽

2013 ◽

Vol 47 (2) ◽

pp. 97-183 ◽

Cited By ~ 41

Author(s):

Natale Quartuccio ◽

Giorgio Treglia ◽

Marco Salsano ◽

Maria Vittoria Mattoli ◽

Barbara Muoio ◽

...

Keyword(s):

Positron Emission Tomography ◽

Fdg Pet ◽

Emission Tomography ◽

Conventional Imaging ◽

Imaging Methods ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Fluorine 18 Fluorodeoxyglucose

Background.The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS).Methods. A comprehensive literature search of published studies through October 10th, 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed.Results. We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OSConclusions.Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning.

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