Clinical impact of 18F-FDG PET/CT in the pretreatment evaluation of patients with locally advanced cervical carcinoma
Nuclear Medicine Communications, cilt.33, sa.10, ss.1081-1088, 2012 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 10
- Basım Tarihi: 2012
- Doi Numarası: 10.1097/mnm.0b013e3283570fd3
- Dergi Adı: Nuclear Medicine Communications
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.1081-1088
- Anahtar Kelimeler: cervical carcinoma, magnetic resonance imaging, positron emission tomography/computed tomography, radiotherapy planning, staging
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: The aim of this study was to evaluate the impact of F-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) on the pretreatment evaluation of patients with locally advanced cervical carcinoma. Method: Forty-seven patients with stage 2b-4a cervical carcinoma underwent F-FDG PET/CT for initial staging and pretreatment evaluation. Concomitant pelvic/abdominal MRI was performed in 38 patients. The contribution of PET/CT to treatment planning was evaluated, and the prognostic performance of PET/CT was compared with that of MRI. Lymph node (LN) status on PET/CT was correlated with patient follow-up data. Results: PET/CT detected hypermetabolic LNs in 39/47 patients. In 24/39 patients (62%), PET/CT was found to be superior to MRI. In 13/24 patients (54%), PET/CT detected para-aortic±pelvic LNs, which were not found on MRI. PET/CT successfully detected distant metastases in 10 patients and peritonitis carcinomatosa in one patient; these patients were upstaged clinically. Overall, PET/CT has led to modifications in the extent of the radiotherapy field in 34% of patients and to major alterations in treatment plans in 23% of patients with widespread disease. The frequency of PET-positive LNs was significantly lower in patients who were alive without disease at the time of last follow-up (60%) compared with patients with persistent disease and nonsurvivors (100%, P=0.012). Conclusion: The presence of PET-positive LNs has prognostic significance in patients with cervical carcinoma. PET/CT has the potential to show both lymphatic and distant metastases, which results in modifications to the chemoradiotherapeutic regimen. The use of PET/CT must be included in the initial workup of patients with locally advanced cervical carcinoma. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.