Role of PET–CT Scan in Gynaeconcology

Abstract

The purpose of this study This study was undertaken to evaluate the role of positron emission tomography-CT (PET-CT) in diagnosis and management of gynecological malignancies in primary and recurrent settings and also to investigate its role in inappropriately treated patients, for pretreatment evaluation (staging) to help in proper therapeutic management. Method This is a retrospective study of 56 patients of gynecological malignancy registered in Gujarat Cancer Research Institute from June 2011 to December 2013. Results Out of 56 cases where PET was done, the results were as follows: carcinoma cervix-23, carcinoma ovary-20, carcinoma endometrium-9, carcinoma vulva-1, carcinoma vagina-2, and GTN-1. PET scan was negative in 37 % of patients where CT scan was suspicious, which changed the therapeutic modality and prevented further unnecessary interventions. In cases where clinical suspicion of recurrence was high based on rising tumor marker and CT scan was negative, subsequent PET-CT was able to pick up malignancy in 75 % cases. Eleven patients (25 %) with suspected recurrence with inconclusive CT scan and negative PET-CT scan were kept on follow-up, thus reducing further morbidity and cost. Conclusion Addition of PET-CT, a noninvasive method to the oncologist's imaging armamentarium may ultimately improve both outcomes and costs by altering management strategies in primary and recurrent settings. The potential use of PET-CT appears promising in several decisionmaking steps in the management of patients with gynecological malignancy. It defines the extent of metastatic disease which enables the clinician to decide regarding salvageable surgical intervention or palliative measures.

A Review of Nuclear Medicine Approaches in the Diagnosis and the Treatment of Gynecological Malignancies

“…Pawar et al assessed the success rate of PET/CT in a retrospective study of 56 patients with gynecological malignancy including cervix carcinomas (23 patients). It was shown that PET/CT offers a high diagnostic accuracy, both in the evaluation of suspected tumor recurrence and in persistent disease [ 26 ]. The authors concluded that PET/CT has particular value in primary cervical cancer, which is related to the diagnosis of extra-pelvic abnormalities, the detection of recurrence, and the monitoring of patients after treatment [ 26 ].…”

“…It was shown that PET/CT offers a high diagnostic accuracy, both in the evaluation of suspected tumor recurrence and in persistent disease [ 26 ]. The authors concluded that PET/CT has particular value in primary cervical cancer, which is related to the diagnosis of extra-pelvic abnormalities, the detection of recurrence, and the monitoring of patients after treatment [ 26 ]. In another retrospective analysis of the accuracy of [ 18 F]FDG PET/CT, the rate of success in the initial stages of cervical tumors was estimated to be 100% [ 27 ].…”