Browse > Article

Role of FDG-PET in the Diagnosis of Recurrence and Assessment of Therapeutic Response in Cervical Cancer and Ovarian Cancer Patients: Comparison of Diagnostic Report between PET, Abdominal a and Tumor Marker  

Han, You-Mie (Department of Nuclear Medicine, Korea University College of Medicine)
Choe, Jae-Gol (Department of Nuclear Medicine, Korea University College of Medicine)
Kang, Bung-Chul (Department of Radiology, Ewha Womans University College of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.42, no.3, 2008 , pp. 201-208 More about this Journal
Abstract
Purpose: We aimed to assess the role of positron emission tomography using fluorodeoxyglucose (FDG-PET) in the diagnosis of recurrence or the assessment of therapeutic response in cervical and ovarian cancer patients through making a comparison between FDG-PET, abdominal computed tomography (CT) and serum tumor marker. Materials and methods: We included 103 cases (67 patients) performed FDG-PET and abdominal CT. There were 42 cervical cancers and 61 ovarian cancers. We retrospectively reviewed the interpretations of PET and CT images as well as the level of tumor marker. We calculated their sensitivity, specificity, positive predictive value and negative predictive value for these three modalities. And then we analyzed the differences between these three modalities. Results: Tumor recurrences were diagnosed in 37 cases (11 cervical cancers and 26 ovarian cancers). For PET, CT and tumor marker, in cervical cancer group, sensitivity was 100% (11/11), 54.5% (6/11) and 81.1% (9/11), respectively. And specificity was 93.6% (29/31), 93.6% (29/31) and 100% (31/31). In ovarian cancer group, sensitivity was 96.2% (25/26), 84.6% (22/26) and 80.8% (21/26), and specificity was 94.3% (33/35), 94.3% (33/35), 94.3% (33/35), PET was highly sensitive to detect the intraperitoneal and extraperitoneal metastasis with the help of the CT images to localize the lesions. However, CT had limitations in differentiation of the recurrent tumor from benign fibrotic tissue, identification of viable tumors at the interface of tissues, and detecting extraperitoneal lesions. Conclusion: FDG-PET can be an essential modality to detect the recurrent or residual tumors in gynecologic cancer patients because of its great field of the application and high sensitivity.
Keywords
FDG PET; gynecologic; ovarian cancer; cervical cancer;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Bodurka-Bevers D, Morris M, Eifel PJ, levenback C, Bevers MW, Lucas KR, et al. Posttherapy surveillance of women with cervical cancer: an outcomes analysis. Gynecol Oncol 2000;78:187-93   DOI   ScienceOn
2 Sugawara Y, Eisbruch A, Kosuda S, Recker BE, Kison PV, Wahl RL. Evaluation of FDG PET in patients with cervical cancer. J Nucl Med 1999;40:1125-31
3 Kerr IG, Manji MF, Powe J, Bakheet S, Al Suhaibani H, Subhi J. Positron emission tomography for the evaluation of metastases in patients with carcinoma of the cervix: a retrospective review. Gynecol Oncol 2001;81:477-80   DOI   ScienceOn
4 Zimny M, Siggelkow W, Schroder W, Nowak B, Biemann S, Rath W, et al. 2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of recurrent ovarian cancer. Gynecol Oncol 2001;83:310-5   DOI   ScienceOn
5 Rutledge FN, Smith JP, Wharton JT, O'Ouinn AG. Pelvic exenteration: analysis of 296 patients. Am J Obstet Gynecol 1977; 129:881-92   DOI
6 Rose PG, Faulhaber P, Miraldi F, Abdul-Karim FW. Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. Gynecol Oncol 2001;82:17-21   DOI   ScienceOn
7 Kim S, Chung JK, Kang SB, Kim MH, Jeong JM, Lee DS, et al [18F]FDG PET as a substitute for second-look laparotomy in patients with advanced ovarian carcinoma. Eur J Nucl Med Mol Imaging 2004; 31:196-201   DOI
8 Sijmons EA, Heintz AP. Second-look and second surgery: second chance or second best? Semin Surg Oncol 2000;19:54-61   DOI   ScienceOn
9 Niloff JM, Bast RC Jr, Schaetzl EM, Knapp RC. Predictive value of CA 125 antigen levels in second-look procedures for ovarian cancer. Am J Obstet Gynecol 1985;151:981-6   DOI
10 Karlan By, Hawkins R, Hoh C, Lee M, Tse N, Cane P, et al. Whole-body positron emission tomography with 2-[18F]-fluoro-2-deosy-D-glucese can detect recurrent ovarian carcinoma. Gynecol Oncol 1993;51:175-81   DOI   ScienceOn
11 Minn H, Kangas, L, Knuutila V, Paul R, Sipila H. Determination of 2-fluoro-2-deoxy-D-glucose uptake and ATP level for evaluating drug effects in neoplastic cells. Res Exp Med 1991;191:27-35   DOI
12 Prayer L, Kainz C, Kramer J, Stiglbauer R, Schurawitzki H, Baldt M, et al. CT and MR accuracy in the detection of tumor recurrence in patients treated for ovarian cancer. J Comput Assist Tomogr 1993;17:626-32   DOI   ScienceOn
13 Lawhead RA Jr, Clark DG, Smith DH, Pierce VK, Lewis JL Jr. Pelvic exenteration for recurrent or persistent gynecologic malignancies: a 10-year review of the Memorial Sloan-Kettering Cancer Center experience (1972-1981). Gynecol Oncol 1989;33: 279-82   DOI   ScienceOn
14 Lai CH, Huang KG, See LC, Yen TC, Tsai CS, Chang TC, et al. Restaging of recurrent cervical carcinoma with dual-phase [18F]fluoro-2-deoxy-D-glucose positron emission tomography. Cancer 2004;100: 544-52   DOI   ScienceOn
15 Nakamoto Y, Saga T, Ishimori T, Mamede M, Togashi K, Higuchi T, et al. Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. Am J Roentgenol 2001;176:1449-54   DOI   ScienceOn
16 Hricak H, Yu KK. Radiology in invasive cervical cancer. Am J Roentgenol 1996;167:1101-8   DOI
17 Park DH, Kim KH, Park SY, Lee BH, Choi CW, chin SY. Diagnosis of recurrent uterine cervical cancer: computed tomography versus positron emission tomography. Korean J Radiol 2000;1:51-5   DOI
18 Belhocine T, Thille A, Fridman V, Albert A, Seidel L, Nickers P, et al. Contribution of whole-body FDG PET imaging in the management of cervical cancer. Gynecol Oncol 2002;87:90-7   DOI   ScienceOn
19 Ryu SY, Kim MH, Choi SC, Choi CW, Lee KH. Detection of early recurrence with 18F-FDG PET in patients with cervical cancer. J Nucl Med 2003;44:347-52
20 Buy JN, Moss AA, Ghossain MA, Sciot C, Malbec L, Vadrot D, et al. Peritoneal implants from ovarian tumors: CT findings. Radiology 1988;169:691-4   DOI
21 Rose PG, Reuter KL, Nelson BE, Sirois J, Fournier L, Reale FR, et al. The impact of CA-125 on the sensitivity of abdominal /pelvic CT scan before second -look laparotomy in advanced ovarian cancer. Int J Gynecol Cancer 1996;6:213-8   DOI
22 Silverman PM, Osborne M, Dunnick NR, Bandy LC. CT prior to second-look Operation in ovarian cancer. Am J Roentgenol 1988; 150:829-32   DOI   ScienceOn