Low Value of [18F]-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography in Primary Staging of Early-Stage Cervical Cancer Before Radical Hysterectomy

2006 ◽  
Vol 24 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Hung-Hsueh Chou ◽  
Ting-Chang Chang ◽  
Tzu-Chen Yen ◽  
Koon-Kwan Ng ◽  
Swei Hsueh ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Radical Hysterectomy ◽  
Fdg Pet ◽  
Early Stage ◽  
Emission Tomography ◽  
Dual Phase ◽  
Primary Staging ◽  
Positron Emission ◽  
Early Stage Cervical Cancer

Purpose The role of positron emission tomography (PET) with [18F]-fluoro-2-deoxy-d-glucose (FDG) in early-stage cervical cancer is unclear. We aimed to investigate the clinical benefit of FDG-PET in primary staging before radical hysterectomy and pelvic lymphadenectomy (RH-PLND). Patients and Methods Patients with untreated stage IA2 to IIA adenocarcinoma (AD) or adenosquamous carcinoma (ASC) or nonbulky (≤ 4 cm) squamous cell carcinoma cervical cancer with magnetic resonance imaging (MRI) –defined negative nodal metastasis were enrolled onto a prospective study with a two-stage design. All patients had a preoperative dual-phase FDG-PET, technetium-99m–sulfur colloid lymphoscintigraphy, and intraoperative sentinel lymph node (LN) detection at RH-PLND. The gold standard of LN metastasis is histologic. A sample size of 120 patients was calculated to fit study aims (diagnostic efficacy of PET and sentinel LN sampling). An interim analysis was performed when 60 patients were accrued, which led to the current report. Results There were 36 SCCs, 20 ADs, and four ASCs. Of the 60 patients, 10 (16.7%) had pelvic LN metastases, and one (1.7%) had para-aortic LN (PALN) metastasis histologically. FDG-PET detected the single PALN metastasis (one of one patient) but detected only one (10%) of the 10 pelvic LN metastases. The PET false-negative pelvic LN micrometastases measured a median of 4.0 × 3.0 mm (range, 0.5 × 0.5 to 7 × 6 mm). The second stage of this trial will be continued without PET. Conclusion This study shows that dual-phase FDG-PET has little value in primary, nonbulky, stage IA2 to IIA and MRI-defined, LN-negative cervical cancer.

Value of Dual-Phase 2-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography in Cervical Cancer

2003 ◽  
Vol 21 (19) ◽  
pp. 3651-3658 ◽  
Author(s):  
Tzu-Chen Yen ◽  
Koon-Kwan Ng ◽  
Shih-Ya Ma ◽  
Hung-Hsueh Chou ◽  
Chien-Sheng Tsai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Characteristic Curve ◽  
Locally Advanced ◽  
Emission Tomography ◽  
Dual Phase ◽  
Recurrent Cervical Cancer ◽  
Metastatic Lesions ◽  
Positron Emission

Purpose: The role of positron emission tomography (PET) with fluorine-18–labeled fluoro-2-deoxy-d-glucose (FDG) in cervical cancer has not yet been well defined. We conducted a prospective study to investigate its efficacy in comparison with magnetic resonance imaging and/or computed tomography (MRI-CT). Materials and Methods: Patients with untreated locally advanced (35%) or recurrent (65%) cervical cancer were enrolled onto this study. In the first part of this study, 41 patients had a conventional FDG-PET (40 minutes after injection), and in the second part, 94 patients received dual-phase PET (at both 40 minutes and 3 hours after injection). The overall results of PET scans were compared with MRI-CT, and the two protocols of PET were also compared with each other. Lesion status was determined by pathology results or clinical follow-up. The receiver operating characteristic curve method with area under the curve (AUC) calculation was used to evaluate the discriminative power. Results: Overall (N = 135), FDG-PET was significantly superior to MRI-CT in identifying metastatic lesions (AUC, 0.971 v 0.879; P = .039), although the diagnostic accuracy was similar for local tumors. Dual-phase PET was also significantly better than the 40-minute PET (n = 94). The latter accurately recognized 70% of metastatic lesions and the former detected 90% (AUC, 0.943 v 0.951; P = .007). Dual-phase FDG-PET changed treatment of 29 patients (31%; upstaging 27% and downstaging 4%). Conclusion: This study shows that dual-phase FDG-PET is superior to conventional FDG-PET or MRI-CT in the evaluation of metastatic lesions in locally advanced or recurrent cervical cancer.

Role of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in re-recurrent cervical cancer

2006 ◽  
Vol 16 (6) ◽  
pp. 1994-2003 ◽  
Author(s):  
C.-T. Lin ◽  
T.-C. Yen ◽  
T.-C. Chang ◽  
K.-K. Ng ◽  
C.-S. Tsai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Scoring System ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Emission Tomography ◽  
Recurrent Cervical Cancer ◽  
Positron Emission

Cervical cancer patients with histologically documented re-recurrence after curative salvage therapy or unexplained tumor marker elevation (negative computed tomography and/or magnetic resonance imaging [CT-MRI]) proven to be a re-recurrence when a further attempt for cure (or control of cancer) appeared feasible were enrolled. Lesion status was determined from pathology or clinical follow-up for at least 12 months. Management decisions were recorded with CT-MRI alone and incorporating [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), respectively. The benefits calculated were based on clinical impact because of the FDG-PET findings. Cox proportional hazards model was used to select independent prognostic covariates. Of the 26 patients who were eligible for analysis, 12 (46.2%) patients had positive impacts due to PET. Squamous cell carcinoma (SCC,P= 0.029), re-recurrence at distant metastasis only (P= 0.012), and level of SCC antigen ≤4 ng/mL (P= 0.005) were significantly associated with better survival. A scoring system using these covariates defined three distinct prognostic groups (P= 0.0001). Patients with score 0 had a 36-month cumulative survival rate of 80%. Using this prognostic scoring system, FDG-PET may facilitate selecting appropriate management for the individual patient with re-recurrent cervical cancer.

scholarly journals Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with 18F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer

2019 ◽  
Vol 29 (9) ◽  
pp. 1351-1354
Author(s):  
Alexander J Lin ◽  
Jason D Wright ◽  
Farrokh Dehdashti ◽  
Barry A Siegel ◽  
Stephanie Markovina ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Fdg Pet ◽  
Early Stage ◽  
Squamous Carcinoma ◽  
Nodal Metastasis ◽  
Tumor Histology ◽  
Positron Emission ◽  
Early Stage Cervical Cancer ◽  
Sensitivity Specificity

Objective18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) detection of metastatic nodal disease is useful for guiding cervical cancer treatment but the impact of tumor histology is unknown. This study reports the detection of FDG avid pelvic and para-aortic lymph nodes in patients with early stage cervical cancer with squamous carcinoma and adenocarcinoma tumor histology.MethodsPatients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-2 cervical cancer who underwent pre-surgical FDG-PET between March 1999 and February 2018 were identified in a tertiary academic center database. All patients had radical hysterectomy with pelvic and para-aortic lymph node dissection. Detection of pelvic and para-aortic lymph nodes by FDG-PET versus surgical dissection was compared. FDG-PET sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined and stratified by tumor histology.ResultsWe identified 212 patients with early stage cervical cancer (84% FIGO IB1, 16% IB2) who underwent pre-surgical FDG-PET; 137 (65%) patients had squamous carcinoma and 75 (35%) patients had adenocarcinoma. PET/computed tomography was performed in 189 (89%) patients and 23 (11%) had PET only. Surgical dissection revealed positive pelvic and para-aortic lymph nodes in 25% and 3.3% of patients, respectively. For squamous carcinoma, sensitivity, specificity, PPV, and NPV of FDG-PET for pelvic nodal metastasis were 44%, 99%, 95%, and 78%, respectively. For adenocarcinoma, the corresponding results for pelvic nodal metastasis were 25%, 99%, 67%, and 92%, respectively. The overall values for sensitivity, specificity, PPV, and NPV of FDG-PET for para-aortic nodal metastasis were 29%, 99%, 67%, and 98%, respectively.DiscussionPelvic nodal metastasis was less likely to be detected by FDG-PET in patients with early stage adenocarcinoma than with squamous carcinoma.

scholarly journals 18F-FDG PET/MRI in adult sarcomas

2020 ◽  
Vol 8 (6) ◽  
pp. 405-412
Author(s):  
Gianluca Cassarino ◽  
Laura Evangelista ◽  
Chiara Giraudo ◽  
Alfio Capizzi ◽  
Giovanni Carretta ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Early Stage ◽  
Soft Tissue Sarcomas ◽  
Emission Tomography ◽  
Response To Treatment ◽  
Early Stage Disease ◽  
Positron Emission ◽  
Stage Disease ◽  
18F Fdg

Abstract Aim This mini-review aims to summarize the main findings on PET/MRI in patients with sarcomas. Materials and methods A literature search was carried out on MEDLINE databases, such as PubMed, Scopus, Web of Science and Google Scholar, using the search terms “PET”, “positron emission tomography”, “PET/MRI”, “positron emission tomography/magnetic resonance imaging”, and “sarcoma”. No restrictions (i.e. language, age, type of manuscript, or the like) were applied to the search strategy. Abstracts, reviews, letters to editors, and editorials were excluded. Results Eight studies were ultimately included. From 2013 to 2019, a total of 154 adult patients with sarcomas underwent 18F-fluorodeoxyglucose (18F-FDG) PET/MRI. Of these patients, 129 had soft tissue sarcomas (STS), 5 had bone sarcomas, and 20 had cardiac masses. Thirty-two patients had PET/MRI for early-stage disease, 45 for recurrences, and 57 for the assessment of response to treatment. For staging purposes, the studies suggest that PET/MRI can significantly improve the delineation of surgical margins. At restaging, PET/MRI can also detect sarcoma recurrences more accurately than conventional imaging. Conclusions 18F-FDG PET/MRI has promising indications in patients with sarcomas, from disease staging to the assessment of response to treatment. Further studies are warranted to confirm these results, especially in subgroups with specific histopathological features.

18F-FDG-PET/CT is of limited value in primary staging of early stage cervical cancer

2014 ◽  
Vol 40 (1) ◽  
pp. 127-133 ◽  
Author(s):  
Dearbhail O. Driscoll ◽  
Darragh Halpenny ◽  
Ciaran Johnston ◽  
Niall Sheehy ◽  
Mary Keogan
Keyword(s):  
Cervical Cancer ◽  
Fdg Pet ◽  
Early Stage ◽  
Primary Staging ◽  
Pet Ct ◽  
Early Stage Cervical Cancer ◽  
18F Fdg ◽  
Fdg Pet Ct
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