Molecular Imaging for Radiotherapy Planning and Response Assessment for Cervical Cancer.

Positron emission tomography (PET) with [18F]fluorodeoxyglucose (FDG) leverages imaging contrast from accelerated and aberrant glucose metabolism, which is a hallmark of cancer. FDG-PET is essential for assessing involved lymph nodes and distant metastases for cervical cancer. It is also utilized for target delineation in radiation treatment planning, with investigations into functional bone marrow sparing intensity modulated radiation therapy. Tumor heterogeneity in FDG-uptake is part of a radiomics approach to potentially escalate treatment to radiation-resistant tumors. Standardizing posttreatment PET surveillance could also allow early surgical salvage of recurrent tumors. The future of molecular imaging in cervical cancer will require development of novel PET tracers to personalize treatments based on tumor biology.