Korean J Radiol.  2000 Mar;1(1):51-55. 10.3348/kjr.2000.1.1.51.

Diagnosis of Recurrent Uterine Cervical Cancer: Computed Tomography versus Positron Emission Tomography

• Park DH
• Kim KH
• Park SY
• Lee BH
• Choi CW
• Chin SY

• KMID: 1777296
• DOI: http://doi.org/10.3348/kjr.2000.1.1.51

Abstract

OBJECTIVE
To determine the accuracy of CT and positron emission tomography (PET) in the diagnosis of recurrent uterine cervical cancer. MATERIALS AND METHODS: Imaging findings of CT and PET in 36 patients (mean age, 53 years) in whom recurrent uterine cervical cancer was suspected were analyzed retrospectively. Between October 1997 and May 1998, they had undergone surgery and/or radiation therapy. Tumor recurrence was confirmed by pathologic examination or follow-up studies. RESULTS: In detecting recurrent uterine cervical cancer, the sensitivity, specificity, and accuracy of CT were 77.8%, 83.3%, and 80.5%, respectively, while for PET, the corresponding figures were 100%, 94.4%, and 97.2%. The Chisquare test revealed no significant difference in specificity (p = .2888), but significant differences in sensitivity (p = .0339) and accuracy (p = .0244). CONCLUSION: PET proved to be a reliable screening method for detecting recurrent uterine cervical cancer, but to determine the anatomical localization of recurrent tumors, and thus decide an adequate treatment plan, CT was eventually needed.

Keyword

Uterine neoplasms, CT; Uterine neoplasms, radionuclide studies; Positron emission tomography (PET), comparative studies

MeSH Terms

Adult
Cervix Neoplasms/*radiography/*radionuclide imaging
Comparative Study
Contrast Media
Female
Fludeoxyglucose F 18/diagnostic use
Human
Middle Age
Neoplasm Recurrence, Local/*radiography/*radionuclide imaging
Radiopharmaceuticals/diagnostic use
Sensitivity and Specificity
*Tomography, Emission-Computed
*Tomography, X-Ray Computed

Figure

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  Fig. 1 A 39-year-old woman who had undergone radical hysterectomy due to uterine cervical carcinoma. A. Enhanced CT scan shows soft tissue mass on the left pelvic side wall (arrow). B. PET scan shows no hypermetabolic site in the pelvis. Since no interval change was seen during follow-up study, we concluded that this was a case of postoperative fibrosis. The highly metabolic lesion in left abdomen (arrow) is due to artifactual accumulation of FDG in ascending colon.

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  Fig. 2 A 52-year-old woman who had undergone radiation therapy due to uterine cervical cancer. A. Enhanced CT scan shows lymph node smaller than 1cm in the para-aortic area (arrow). B. PET scan shows hypermetabolic area (SUV = 3.8 ml/kg) in the para-aortic chain (arrow).

• 

  Fig. 3 A 41-year-old woman with uterine cervical cancer. False positive PET scan due to pulmonary tuberculosis. A. CT scan shows multiple nodules in left upper lung (arrows). B. PET scan shows hypermetabolic lesion (SUV = 9.6 ml/kg) in left upper lung (arrow). Tuberculosis was confirmed by polymerase chain reaction of the sputum.

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