Minkyung Lee1, Yukyung Lee1, Kyung Hoon Hwang1, Wonsick Choe2, Chan Yong Park3. 1. Department of Nuclear Medicine, Gachon University, Gil Hospital, Incheon, South Korea. 2. Department of Nuclear Medicine, Kangbuk Samsung Hospital, Seoul, Korea. 3. Department of Gynecologic Oncology, Gachon University, Gil Hospital, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760 South Korea.
Abstract
OBJECTIVE: Until now, serum tumor markers, physical examination, and conventional imaging modalities, such as CT or MRI, have been used in assessment of recurrence of cervical cancer after treatment. However, CT and MRI provide only anatomical data, which makes analysis of post-treatment change difficult. This study aims to explore the effectiveness of PET/CT, a new scanning device that combines PET and CT, in evaluation of cervical cancer lesions in patients with suspected recurrence. METHODS: We studied 51 patients suspected of recurrence among those who underwent F-18 FDG PET/CT for cervical cancer follow-up at Gachon University Gil Hospital between June 2006 and August 2009. Patients were considered to be at risk for recurrence if they reported symptoms that were clinically suggestive of recurrence, or if physical examination showed abnormalities, serum tumor marker levels rose, or follow-up images revealed changes, such as new lesions or swelling of previous sites. Sensitivity, accuracy, specificity, and positive and negative predictive values of PET/CT were measured. RESULTS: A total of 37 patients were confirmed with recurrence or metastasis, 13 of whom were diagnosed histologically. Measured across all patients, PET/CT scored 97.3% on sensitivity, 71.4% on specificity, a positive predictive value of 90%, a negative predictive value of 90.9%, and an accuracy of 90.2%. PET/CT yielded only one false negative diagnosis and four false positives. CONCLUSION: As F-18 FDG PET/CT has high sensitivity and negative predictive value in diagnosis of recurrent cervical cancers, it is expected that it will be useful for clinical determination of recurrence and prevention of unnecessary additional treatments. The hope is that a future study on a larger scale will contribute further to determination of the efficacy of PET/CT.
OBJECTIVE: Until now, serum tumor markers, physical examination, and conventional imaging modalities, such as CT or MRI, have been used in assessment of recurrence of cervical cancer after treatment. However, CT and MRI provide only anatomical data, which makes analysis of post-treatment change difficult. This study aims to explore the effectiveness of PET/CT, a new scanning device that combines PET and CT, in evaluation of cervical cancer lesions in patients with suspected recurrence. METHODS: We studied 51 patients suspected of recurrence among those who underwent F-18 FDG PET/CT for cervical cancer follow-up at Gachon University Gil Hospital between June 2006 and August 2009. Patients were considered to be at risk for recurrence if they reported symptoms that were clinically suggestive of recurrence, or if physical examination showed abnormalities, serum tumor marker levels rose, or follow-up images revealed changes, such as new lesions or swelling of previous sites. Sensitivity, accuracy, specificity, and positive and negative predictive values of PET/CT were measured. RESULTS: A total of 37 patients were confirmed with recurrence or metastasis, 13 of whom were diagnosed histologically. Measured across all patients, PET/CT scored 97.3% on sensitivity, 71.4% on specificity, a positive predictive value of 90%, a negative predictive value of 90.9%, and an accuracy of 90.2%. PET/CT yielded only one false negative diagnosis and four false positives. CONCLUSION: As F-18 FDG PET/CT has high sensitivity and negative predictive value in diagnosis of recurrent cervical cancers, it is expected that it will be useful for clinical determination of recurrence and prevention of unnecessary additional treatments. The hope is that a future study on a larger scale will contribute further to determination of the efficacy of PET/CT.
Authors: K Hatano; Y Sekiya; H Araki; M Sakai; T Togawa; Y Narita; Y Akiyama; S Kimura; H Ito Journal: Int J Radiat Oncol Biol Phys Date: 1999-10-01 Impact factor: 7.038
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