Prognostic Value of Positron Emission Tomography Using F-18-Fluorodeoxyglucose in Patients with Cervical Cancer Undergoing Radiotherapy

Nakamoto, Yuji; Eisbruch, Avraham; Achtyes, Eric D.; Sugawara, Yumi; Reynolds, Kevin R.; Johnston, Carolyn; Wahl, Richard L.

doi:10.1006/gyno.2001.6504

Cited by 57 publications

(30 citation statements)

References 18 publications

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“…Several authors have investigated the usefulness of PET for postoperative or post-therapy surveillance of patients with cervical cancer and found that the sensitivity, specificity, and accuracy were 86-100%, 60-94%, and 70-97%, respectively (Table 4) [12][13][14][15][16][17][18][19]. These studies revealed that false-negative cases included local recurrence in the retrovesical region, pelvic recurrence, lung metastasis, peritoneal dissemination, pelvic LN metastasis, and para-aortic LN metastasis, whereas false-positive cases were due to inflammatory lesions, physiological uptake, and postoperative change.…”

Section: Discussionmentioning

confidence: 99%

“…There have been several studies of FDG-PET [12][13][14][15][16][17][18][19] and only two reports of integrated FDG-PET/CT [20,21] describing their usefulness for the diagnosis of recurrent uterine cervical cancers. Chung et al [20] and Sironi et al [21] discussed the diagnostic accuracy of PET/CT, but did not compare PET/CT interpretation with PET-alone interpretation.…”

Section: Introductionmentioning

confidence: 99%

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Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

et al. 2008

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The purpose is to evaluate the accuracy of integrated FDG-PET/CT, compared with PET alone, for diagnosis of suspected recurrence of uterine cervical cancer. Fifty-two women who had undergone treatment for histopathologically proven cervical cancer received PET/CT with suspected recurrence. PET-alone and integrated PET/CT images were evaluated by two different experienced radiologists by consensus for each investigation. A final diagnosis was confirmed by histopathology, radiological imaging, and clinical follow-up for over 1 year. Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/CT were 92.0% (23/25), 92.6% (25/27), and 92.3% (48/52), respectively, while for PET, the corresponding figures were 80.0% (20/25), 77.8% (21/27), and 78.8% (41/52), respectively. PET/CT resolved the false-positive PET results due to hypermetabolic activity of benign/inflammatory lesions and physiological variants, and was able to detect lung metastasis, local recurrence, peritoneal dissemination, para-aortic lymph node metastasis, and pelvic lymph node metastasis missed by PET alone. However, tiny local recurrence and lymph node metastasis could not be detected even by PET/CT. FDG-PET/CT is a useful complementary modality for providing good anatomic and functional localization of sites of recurrence during follow-up of patients with cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

et al. 2008

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“…For instance, some benign tumours or infectious diseases may also take up 18 F-FDG, examples including leiomyoma, benign serous cystadenoma, benign fibroids, endometriosis and endometrioma [36,37,38]. Similarly, the inflammatory changes that follow the primary therapy (recent surgery or radiation therapy) can induce intense uptake of the metabolic tracer [39]. Other false-positive results are related to the physiological retention of the tracer in the urinary system or the bowels.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of 18F-FDG PET in the post-therapy surveillance of endometrial carcinoma

Belhocine¹,

Barsy²,

Hustinx³

et al. 2002

Eur J Nucl Med

123

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Abstract. The aim of this study was to assess the usefulness of fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) in the post-therapy surveillance of endometrial carcinomas. Forty-one fully corrected whole-body PET studies were performed in 34 women with previously treated endometrial cancers as a part of their follow-up programme. In 28 studies, FDG PET was indicated to localise a recurrence suspected at the control visits on the basis of clinical examination and/or radiological abnormalities (chest X-ray, CT or MRI) and/or elevated tumour marker levels (CA125, CEA). Another 13 studies were performed as a simple surveillance procedure. Overall, in 26 studies PET detected recurrent disease, which was confirmed either by histology (n=7) or by clinical and radiological outcomes (n=19). In 88% of the cases, the PET findings confirmed recurrence suggested by routine follow-up. In the remaining 12% of cases, PET detected asymptomatic recurrences that were unsuspected at the control visits. Whole-body PET accurately localised the site of confirmed recurrences as being above and below the diaphragm in 50%, only below the diaphragm in 35% and only above the diaphragm in 15%. In one patient, however, PET missed microscopic lung metastases shown on thoracic CT, and in three studies, metabolic imaging results were not confirmed. In 11 of 12 negative PET studies, no subsequent clinical or radiological recurrences were observed with a median follow-up of 10 months. Overall, the results of PET agreed well with the final diagnosis (Cohen's kappa coefficient =0.78). In 9/26 patients (35%) with confirmed recurrences, the PET findings significantly altered the treatment choice by detecting either clinically or radiologically unsuspected distant metastases. The sensitivity, specificity, diagnostic accuracy and positive and negative predictive values of FDG PET imaging in the post-therapy surveillance of endometrial carcinomas were 96%, 78%, 90%, 89% and 91%, respectively. Indeed, the high likelihood ratio for a positive test result (4.5) and the low likelihood ratio for a negative test result (0.05) demonstrated the clinical utility of metabolic imaging in "ruling in" disease as well as "ruling out" recurrence. In conclusion, whole-body FDG PET appears useful in the post-therapy surveillance of endometrial cancers, both for the accurate localisation of suspected recurrences and for the detection of asymptomatic recurrent disease.

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“…Nakamoto y cols. 71 monitorizaron 20 pacientes mediante estudios PET pre y post-radioterapia, obteniendo una sensibilidad, especificidad y exactitud del 100%, 60% y 70%, respectivamente. Un estudio retrospectivo más reciente de Grigsby y cols.…”

Section: Monitorización De La Respuesta Al Tratamientounclassified

Aportación de la Tomografía por Emisión de Positrones (PET) al manejo de los tumores malignos de ovario y útero

Fernández¹,

Grande

Suárez

et al. 2005

Oncología (Barc.)

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ResumenLa Tomografía por Emisión de Positrones (PET) tiene un valor limitado en el diagnóstico primario y estadificación del cáncer de ovario, aunque puede complementar a los métodos convencionales. Tampoco puede sustituir a la "second-look" dada su baja sensibilidad para detectar enfermedad micronodular. No obstante, en aquellos pacientes en los que se sospeche recurrencia, la resolución de la PET es muy alta y debe considerarse en los casos de marcador CA 125 elevado y técnicas de imágenes convencionales negativas. Los nuevos equipos híbridos PET-TAC mejoran el rendimiento diagnóstico y parece que esta técnica acabará imponiéndose a las cámaras PET dedicadas.En el cáncer de cérvix, la PET es una técnica útil en la estadificación pre-terapéutica no invasiva de la enfermedad, ayudando a una adecuada planificación tanto quirúrgica como radioterápica. El seguimiento con PET permite un diagnóstico precoz y exacto de la enfermedad recurrente, con resultados superiores a las técnicas convencionales. Asimismo, aporta datos predictores en cuanto al pronóstico y a la respuesta a la terapia que pueden ser útiles para identificar aquellos pacientes que precisen de intervenciones más agresivas. La aplicación de la PET en el cáncer de cuerpo uterino, aunque prometedora, necesita de mayor estudio para su validación.

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Prognostic Value of Positron Emission Tomography Using F-18-Fluorodeoxyglucose in Patients with Cervical Cancer Undergoing Radiotherapy

Cited by 57 publications

References 18 publications

Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

Usefulness of 18F-FDG PET in the post-therapy surveillance of endometrial carcinoma

Aportación de la Tomografía por Emisión de Positrones (PET) al manejo de los tumores malignos de ovario y útero

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