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

Yen, Tzu‐Chen; Ng, Koon‐Kwan; Ma, Shih-Ya; Chou, Hung-Hsueh; Tsai, Chien-Sheng; Hsueh, Swei; Chang, Ting‐Chang; Hong, Ji-Hong; See, Lai‐Chu; Lin, Wuu-Jyh; Chen, Jenn-Tzong; Huang, Kuan-Gen; Lui, Kar‐Wai; Lai, Chia-Yun

doi:10.1200/jco.2003.01.102

Cited by 138 publications

(107 citation statements)

References 34 publications

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“…[65][66][67] In a study, including 94 patients, DP (40 minutes and 3 hour) PET imaging resulted superior to conventional PET or CT/magnetic resonance imaging (MRI) in the evaluation of metastatic lesions in locally advanced or recurrent cervical cancer. 65 These data have been confirmed in restaging cervical carcinoma at the time of first recurrence in a group of 40 patients, in whom DP FDG-PET was significantly superior to CT/MRI in identifying metastatic lesions, and so modifying the treatment in 55% of cases. 66 Moreover, the delayed images proved to be particularly useful for the detection of lower para-aortic lymph node metastases.…”

Section: Other Tumorsmentioning

confidence: 99%

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Schillaci

2012

Seminars in Nuclear Medicine

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Positron emission tomography (PET) and positron emission tomography/computed tomography imaging with fluorodeoxyglucose (FDG) are widely used as a powerful evaluation modality in oncological nuclear medicine not only for detecting tumors but also for staging and for therapy monitoring. Nevertheless, there are numerous causes of FDG uptake in benign processes seen on PET images. In fact, the degree of FDG uptake is related to the cellular metabolic rate and the number of glucose transporters. FDG accumulation in tumors is due, in part, to an increased number of glucose transporters in malignant cells. However, FDG is not specific for neoplasms: a similar situation exists in inflammation; activated inflammatory cells demonstrate increased expression of glucose transporters. Therefore, there is growing interest in improving the specificity of FDG-PET in patients with cancer. Preliminary studies showed that in several neoplasms, the uptake of FDG continues to increase for hours after radiopharmaceutical injection, and this difference in the time course of FDG uptake could be useful to improve the accuracy of PET to distinguish benign lesions from malignant ones. Also in experimental cultures, dual-point acquisition (early at 40-60 minutes postinjection and delayed at 90-270 minutes) demonstrated that it is able to differentiate inflammatory from neoplastic tissue. In general, inflammatory tissue is expected to reduce FDG uptake as the time goes by, whereas the uptake in the neoplastic lesions is supposed to be increasing. There is evidence in the recent literature of the clinical usefulness of dual-time-point FDG-PET imaging in a wide variety of malignancies, including those of head and neck, lung, breast, gallbladder, cervix, liver, and in brain tumors. A lesion is likely to be malignant if the standard uptake value increases over time, whereas it is likely to be benign if the standard uptake value is stable or decreases. It is worth noting that in many of these studies, dual-time-point PET improved not only the specificity but also the sensitivity in assessing breast, pulmonary, liver, and other tumors because of increased lesion-to-background ratio, as a consequence of FDG washout from the surrounding normal tissues and increasing neoplastic uptake. Semin Nucl Med 42:267-280

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Section: Other Tumorsmentioning

confidence: 99%

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Schillaci

2012

Seminars in Nuclear Medicine

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“…The extent of lymph node metastases was classified as negative, pelvic, para-aortic or inguinal, supraclavicular, and mediastinal according to the most distant positive site along the route of lymphatic spread as determined by criteria detailed in a previous study. 13 …”

Section: Analysis Of Risk Factors For Hematogenous Bone Metastasismentioning

confidence: 99%

“…The criteria for positive lymph nodes were detailed in a previous study. 13 In the setting of suspicious disease recurrence, no further selection criteria were applied.…”

Section: Patientsmentioning

confidence: 99%

Detection of hematogenous bone metastasis in cervical cancer

Liu

Yen

Chen

et al. 2009

Cancer

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BACKGROUND:In this large‐scale, retrospective study, the authors evaluated the diagnostic performances of computed tomography (CT), magnetic resonance (MR) imaging, and 18F‐fluorodeoxyglucose‐positron emission tomography (18F‐FDG–PET) in detecting hematogenous bone metastasis in patients with cervical cancer. The associated risk factors also were analyzed.METHODS:Patients with invasive cervical cancer who had both 18F‐FDG–PET studies and CT or MR imaging studies were selected. Patients who had either International Federation of Gynecology and Obstetrics (FIGO) stage III/IV disease or positive lymph node metastasis at the time of primary staging and patients who had suspected recurrent disease were included in the analyses. The diagnostic performances of PET was compared with the performance of CT and MR imaging by using the area under the receiver‐operating‐characteristic curve (AUC). Both univariate and multivariate analyses were applied to assess the risk factors for hematogenous bone metastasis at primary staging.RESULTS:PET was more sensitive than CT (P = .004) and was more specific than MR imaging (P = .04). The diagnostic performance of PET was significantly superior to the performance CT (AUC, 0.964 vs 0.662; P < .001) and MR (AUC, 0.966 vs 0.833; P = .033). Both FIGO stage and the extent of lymph node metastases were associated with hematogenous bone metastasis in univariate analysis. However, the extent of lymph node metastases was the only significant risk factor in multivariate analysis (P = .025).CONCLUSIONS:The current study demonstrated the superiority of 18F‐FDG–PET over CT and MR imaging for detecting hematogenous bone metastasis in patients with advanced cervical cancer. Hematogenous bone metastasis in cervical cancer was associated with the extent of lymph node metastases rather than with FIGO stage. Cancer 2009. © 2009 American Cancer Society.

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“…At present, F-18 FDG PET of cervical cancer patients is increasingly being used to assess cervical cancer patients. Several investigators have shown that it is useful for the initial staging of cervical cancer patients [3][4][5][6]. Several reports have also revealed that the maximum levles of FDG uptake reflect tumor aggressiveness and are negatively associated with survival [3, [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

F-18 FDG PET Images of the Cervix at Various Time Points after the Loop Electrosurgical Excision Procedure

Jeong

Min

2010

Nucl Med Mol Imaging

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F-18 FDG PET is useful for monitoring residual or recurrent tumors after surgical resection. We describe five F-18 FDG PET images of three patients who had cervical carcinoma and then underwent a loop electrosurgical excision procedure (LEEP). Two of the images were taken within 15 days and three at least 2 months after LEEP. The earlier F-18 FDG PET images revealed linear hypermetabolic lesions in the cervix that were produced by inflammation. This was confirmed by pathological analysis. The later F-18 FDG PET images did not reveal any remarkable hypermetabolism in the cervix without any treatment. These observations suggest that, to determine the response to LEEP therapy, F-18 FDG PET should not be performed within 15 days of the procedure.

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

Abstract: 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.

Cited by 138 publications

References 34 publications

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Use of Dual-Point Fluorodeoxyglucose Imaging to Enhance Sensitivity and Specificity

Detection of hematogenous bone metastasis in cervical cancer

F-18 FDG PET Images of the Cervix at Various Time Points after the Loop Electrosurgical Excision Procedure

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