FDG-PET in cervical cancer: staging, re-staging and follow-up

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Abstract
Background. Correctly visualising the extent of the disease in cervical cancer is difficult with today's conventional imaging modalities. This paper presents the interim analysis of an on‐going prospective study to evaluate the potential role of FDG‐PET with software fusion with CT images in 3 different clinical settings of cervical cancer. Methods. In Group 1, 10 patients with early stage cervical cancer underwent FDG‐PET 6 months after surgery. Group 2 consisted of 17 patients with locally advanced cervical cancer who underwent FDG‐PET as part of the staging procedure. In Group 3, 12 patients with verified relapse and 3 patients with a strong suspicion thereof underwent FDG‐PET before starting any therapy. The FDG‐PET results were compared with the results of the standard conventional work‐up. All patients had a follow‐up time of at least 6 months. Results. All FDG‐PET scans in Group 1 were true negative. In Group 2, FDG‐PET detected previously unknown locations of metastases in 4 patients, and a synchronous pulmonary carcinoma in 1 patient, resulting in a change in treatment plan for 4 patients. One false negative FDG‐PET result was recorded. In Group 3, FDG‐PET results led to a change in treatment plan for 3 patients. Conclusions. We conclude that FDG‐PET provides crucial information in the pre‐treatment staging procedure in patients with locally advanced or relapsed cervical cancer. However, in the follow‐up of early cervix cancer, FDG‐PET 6 months post‐operatively offered no clinical benefit in this small group of patients.

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