Usefulness of FDG-PET to detect recurrent cervical cancer based on asymptomatically elevated tumor marker serum levels--a preliminary report.

This study was to evaluate the clinical impact of whole body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG) to detect recurrent cervical cancer based on asymptomatically elevated tumor marker levels. Whole-body FDG-PET was performed in 20 patients with suspected recurrent squamous cell carcinoma (SCC) of the cervix and asymptomatic tumor marker of SCC antigen increased serum levels but negative or equivocal other imaging modality results. All of these 20 asymptomatic patients have serum levels of SCC antigen > 1.5 ng/mL. The final diagnosis of recurrent cervical cancer was established by operation/biopsy histopathological findings or clinical follow-up after more than 1 year by additional morphological imaging techniques. Among the 20 patients, the final diagnosis of recurrent cervical cancer was established in 81 lesions of 19 patients. The FDG-PET accurately detected 78/81 lesions. With asymptomatically elevated SCC antigen serum levels, the diagnostic sensitivity and accuracy of FDG-PET to detect recurrent cervical cancer lesions were 97.5% and 94.0%, respectively. The FDG-PET is a useful technique to detect recurrent cervical cancer for patients with asymptomatically elevated SCC antigen serum levels.