FDG-PET Scan in Patients with Cervical Cancer: Experience in Patients with Clinically No Evidence of Disease

Kyu, Lee Jae; Kim, Beob Jong; Hwang, Soon Hyunk; Ryu, Sang Young; Kim, Jong Hoon; Kim, Byoung Gie; Park, Sang Yoon; Lee, Eui Don; Lee, Kyung Hee; Choi, Chang Woon; Lim, Sang Moo

Abstract

OBJECTIVE
The purpose of this study was to investigate the clinical feasibility of FDG-PET (Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer.
METHODS
One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible.
RESULTS
Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%.
CONCLUSION
PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies.