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.
The issue of false positive lymph nodes on [18F] FDG-PET/CT for cervical carcinoma and consequences for treatment