18F-FDG-PET/CT imaging of uterine cervical cancer recurrence in women with and without HIV infection

Abstract

Background: To compare the rate, time and, pattern of recurrence of cervical cancer between patients with and without HIV infection and to determine factors predicting cervical cancer recurrence in patients evaluated by 18 F-FDG-PET/CT. Methods:We reviewed the 18 F-FDG-PET/CT images of patients with histologically proven cervical carcinoma who were presenting with suspected recurrence. We extracted epidemiologic data, previous treatment, histologic subtype, HIV status, viral load and CD4 counts from the electronic laboratory database and the referral form for the 18 F-FDG-PET/CT study. Results:We studied 303 women including 112 HIV-infected patients. FIGO stage III disease was present in 131 patients. Of 198 patients with recurrence, 74 were HIV-infected while 124 were not (p=0.849). HIV infected patients were younger (41.99 ± 9.30 years) compared to HIV-uninfected (50.19 ± 11.09), p<0.001. Local recurrence was present in 125 patients while 100 patients had a distant recurrence. Recurrence occurred at a single site in 88 patients and two or more sites in 110 patients. No significant difference in the recurrent patterns between HIV-infected and uninfected patients. Median time to recurrence was 10.50 months (Range: 6.00-156.00) among HIV-infected versus 12.00 months (IQR:7.00-312.00) among the uninfected, p=0.065. FIGO stage III (p=0.042) and the presence of histological sub-types other than SCC (p=0.005) were significant predictors of recurrence. HIV infection by itself was not significant in predicting recurrence (p=0.843).Conclusions: HIV infection has no significant impact on the rate, time or pattern of recurrence in women with suspected cervical carcinoma recurrence. Advanced disease and histological variant other than SCC are predictive of recurrence.

The Association of Tumor Burden by 18F-FDG PET/CT and Survival in Vulvar Carcinoma

“…We found that HIV-infected patients were younger at diagnosis than HIV-uninfected patients, by an average of almost 13 years. This trend seems to be consistent in other squamous cell carcinomas such as cervical and anal cancers 27–30 . The reason for this younger age at diagnosis may be linked to changing trends in the disease; however, a connection with HPV infection still remains the most well-studied implicating factor.…”

“…This trend seems to be consistent in other squamous cell carcinomas such as cervical and anal cancers. [27][28][29][30] The reason for this younger age at diagnosis may be linked to changing trends in the disease; however, a connection with HPV infection still remains the most well-studied implicating factor. A study by Hampl et al 2 with over 200 women found an increase in the presence of vulva carcinoma in younger patients due to HPV infection.…”

Combination of serum FOXR2 and transvaginal three-dimensional power Doppler ultrasonography in the diagnosis of uterine lesions

“…43 The FDG PET/CT also exhibits good diagnostic performance in endometrial carcinoma 44 and cervical cancer. 45 Numerous studies report on the application of 3D-PDU in various diseases. Data show that the sensitivity of 3D-PDU is higher than that of digital rectal examination, greyscale ultrasonography and power Doppler ultrasonography, but its specificity is lower.…”

Diagnosis of Early Cervical Cancer with a Multimodal Magnetic Resonance Image under the Artificial Intelligence Algorithm

“…Clinically, the initial diagnosis of cervical cancer is generally a gynecological examination, which is less reliable in the diagnosis of parauterine infiltration, degree of infiltration, tumor size, and the distant metastases of lymph nodes or pelvic cavity [ 7 ]. At present, clinical imaging methods, such as magnetic resonance imaging (MRI) plain scan, ultrasound, and computer tomography (CT), are used to evaluate the staging of cervical cancer [ 8 , 9 ]. Ultrasound is simple, fast, and easy to operate, with a relatively cheap price.…”